THE CLINICAL PSYCHOLOGIST IN THE JUVENILE COURTS OF THE UNITED STATES - AN ANALYTICAL AND COMPARATIVE INVESTIGATION

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THE CLINICAL PSYCHOLOGIST IN THE JUVENILE COURTS OF THE UNITED STATES - AN ANALYTICAL AND COMPARATIVE INVESTIGATION

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S p o n so rin g Committee: P ro f e s s o r F re d e ric M. T hrasher, P ro f e s s o r Edward L. Kemp and A s s o c ia te P ro fe s s o r John C. Payne

THE CLINICAL PSYCHOLOGIST IN THE JUVENILE COURTS OF THE UNITED STATES An A n a ly tic a l and C om parative I n v e s tig a tio n

STANLEY B. ZUCKERMAN

S u b m itted in p a r t i a l f u lf illm e n t o f th e re q u ire m e n ts f o r th e degree of Doctor of P h ilo so p h y in th e S chool of Education of New York U n iv e rs ity

1950 * *har*ii#

pSeA

/ ^ I)

STANLEY 2230

B. Z U C K E R M A N

GRAND C O N C O U R S E

BRONX

B7, N E W

YORK F O

r d h a m

TO WHOM IT MAI CONCERN; The stu d en t hereby g u a ra n te e s t h a t n o p a r t o f the d is s e r ta tio n o r document which he has subm itted f o r p u b l i c a t i o n h a s been h e re to fo re published and (or) copyrighted in t h e U n ite d S t a t e s o f America, except in the case of passages quoted from o t h e r p u b l i s h e d so u rc e s ; th a t he i s the sole au th o r and p ro p rie to r of s a i d d i s s e r t a t i o n o r document; th a t the d is s e r ta tio n or document c o n ta in s no m a t t e r w h ic h , i f published, w ill be lib e lo u s or otherw ise i n j u r i o u s , o r i n f r i n g e i n any way the copyright o f any o th er p a rty ; and t h a t he w i l l d e f e n d , indemnify and hold harm less New York U n iv e rsity a g a i n s t a l l s u i t s and proceedings which may be brought and a g a in s t a l l c la im s w hich may b e made a g a in st New York U niversity by reason o f th e p u b l i c a t i o n o f s a i d d is s e r ta tio n o r document.

Signed

75 -

000 cases were

h a n d le d by t h e c o u r t o f which a lm o st 1,000 were d elinquency a c tio n s.

Of

t h e t o t a l num ber o f d e lin q u e n c y c a se s only a v e ry sm all p ro p o rtio n (less th a n 10$) w ere d is p o s e d o f by r e f e r r a l t o n o n -c o u rt a g e n c ie s o r commmity s e rv ic e s .

W hile 928 y o u n g s te rs were re p o rte d a s having been adjudicated

d u r in g th e y e a r b e g in n in g J u ly 1 , 1947, no f i g u r e s on c l i n i c a l services w ere o b ta in e d e i t h e r d u rin g th e f i e l d t r i p , on th e q u e s tio n n a ire returned b y th e c o u r t , an d n o n e w ere a v a ila b le i n th e an n u al r e p o r t .

The intake

s u p e r v is o r r e p l i e d t h a t alth o u g h th e e x a c t f ig u r e o f y o u n g ste rs referred f o r d ia g n o s tic s t u d i e s was n o t a v a i la b l e , th e s e were done f o r " a ll for

161 whoa i t was c o n s id e re d n e c e s s a ry

F u rth er, the lum ber o f y o u n g s te r s r e c e i v ­

ing reg u la r p s y c h i a t r i c tr e a tm e n t under court a u sp ice s c o u ld n o t b e s u p p l i e d . Though e x a c t f i g u r e s a re not a v a ila b le i t d o e s n o t a p p e a r t h a t the court I s e n t i r e l y w ith o u t c l i n i c a l resources.

As a n a t t e r o f f a c t , a

s ta te p s y c h i a t r i s t and s t a t e psychom etrist a re a v a ila b le f o r c o n s u l t a t i o n s and a d d itio n a l s e r v i c e s a r e o b ta in e d on a fee b a s is .

The c a s e w ork s u p e r v i s o r

whom the i n v e s t i g a t o r in te rv ie w e d stre sse d th e r e s o u rc e s w hich t h e community provides t o a s s i s t th e ju v e n ile c o u rt including th e C h a rle s V. C hap in C l i n i c and the P rovidence C h ild G uidance C lin ic .

F a c ilitie s g e n e ra lly a p p e a r

to be taxed b u t c o o p e r a tiv e , and d iagnostic c l i n i c a l e x a m in a tio n s w ere gaid to be o b ta in a b le i n ab o u t two weeks. The i n v e s t i g a t o r h a s th e impression th a t t h e c o u r t i s r e c e p t i v e to the id ea o f c l i n i c a l s e r v i c e s , and q uestionnaire d a t a c o n f i n e d t h e f a c t th a t w h ile th e y w ould l i k e to have a c lin ic a tta c h e d t o t h e c o u r t , such a developm ent i s by no means imminent.

Meanwhile, t h e r e i s n o S p e c ia l

provision — i n th e a b sen ce o f an arrangement under w hich eac h y o u n g s te r can be seen by a t r a i n e d c l i n i c i a n — fo r a screening p la n f o r t h e d e te c ­ tio n of th o se c h ild r e n whom a c lin ic ia n would c o n sid e r m ost i n n e e d o f observation o r h e l p .

I t a p p e a rs , however, th a t where p s y c h o lo g ic a l c o n s u l­

ta tio n s a re p ro v id e d t h e c o u r t looks on c lin ic a l recom m endations w i t h some favor even though th e u ltim a te decision r e s ts w ith t h e ju d g e . The i n v e s t i g a t o r 's su b je c tiv e impression grow ing o u t o f h i s ob­ servations and o t h e r d a ta i s t h a t even considering t h e r e l a t i v e n ew n ess of the o r g a n is a tio n , j u v e n i l e c o u rt c lin ic a l f a c i l i t i e s a r e v e ry f a r from adequate and t h a t t h e e v a s iv e n e s s th a t he found on t h i s p o in t seem s t o have been w a rra n te d by t h e d e a r th of services — e s p e c i a l l y t r e a t m e n t — provided.

162

P e rh a p s th e m ost i n t e r e s t i n g a s p e c t o f th e ju v e n ile court program i n P ro v id e n c e , how ever, i s som ething to u ch ed on i n th e in terv iew but tre a te d i n more d e t a i l I n t h e i r a n n u a l r e p o r t .

The c o u rt e s ta b lis h e d in 1946

th e p o s i t i o n o f P re v e n tio n C o o rd in ato r w ith a view t o g r e a te r u tiliz a tio n o f community r e s o u r c e s o f a p re v e n tiv e n a tu r e .

The work o f the Coordinator

in c lu d e s p r o j e c t s w ith neighborhood o r g a n iz a tio n s and f r a t e r n a l groups, two r a d io pro g ram s aim ed a t p a r e n ts and y o u th , th e fo rm a tio n o f a Youth Council, c o l l a b o r a t i o n i n t h e fo rm a tio n o f C o o rd in a tin g C o u n c ils, and the organiza­ t i o n o f t h e Rhode I s la n d Committee f o r E d u catio n on A lcoholism . The c o u r t h a s , m oreover, a S p e a k e rs' Bureau f o r addressing organi­ z a tio n s a n d l e a d in g d is c u s s io n groups and conducted a course called "Prepar­ a t i o n f o r M a r r ia g e ."

Even i f th e c l i n i c a l s e r v ic e s o f th e new s ta te juven­

i l e c o u r t o f Rhode I s l a n d a r e below w hat would seem t o be d e sira b le , there a p p e a rs t o b e a h o p e fu l aw areness o f and. s ig n s o f c o n s tru c tiv e e ff o r t in im p o r ta n t, p r e v e n tiv e d i r e c t i o n s . New Haven and H a rtfo rd L ik e Rhode I s l a n d , th e ju v e n ile c o u rt f o r C onnecticut i s organized on a s t a t e - w i d e b a s i s .

F o r t h a t r e a s o n , th e i n v e s t i g a t o r 's rep o rt on the

ju v e n i l e c o u r t a n d c l i n i c a l f a c i l i t i e s o f New Haven, a m anufacturing c ity o f o v e r 1 6 0 ,0 0 0 , end o f H a r tfo rd , a m an u fa ctu rin g and in su ra n ce center of o v e r 1 6 6 ,0 0 0 , w i l l b e t r e a t e d t o g e t h e r .

O rganized i n 1942, the juvenile

c o u r t s e r v e s t h e whole s t a t e which i s d iv id e d i n t o th r e e ad m inistrativ e d is tric ts .

U n lik e th e new c o u rt i n P ro v id e n c e , th e C o nnecticut trib u n a l

c o n c e n tr a te s on j u v e n i l e c a se s and le a v e s such fa m ily problem s as support c a se s and d iv o r c e a c t io n s t o th e Dom estic R e la tio n s S e ssio n s of the Super­ i o r C o u rt.

The j u v e n i l e c o u rt i s concerned la r g e ly w ith delinquency cases

and t o a l e s s e r e x t e n t w ith n e g le c t p e t i t i o n s , b u t s e rv e s a ls o fo r the

163 c o lle c tio n o f s u p p o r t a llo w a n c e s .

la delinquency c a s e s , j u r i s d i c t i o n i s ex ­

clusive w ith th e ju v e n i l e c o u r t except in the s ix te e n t o e ig h te e n y e a r a g e range la which a u t h o r i t y nay b e shared with lo c a l c o u rts * Q u a n t i t a t i v e l y , th e b u lk of the oases a re d e lin q u e n c y a c tio n s * Of the more th a n 3 ,9 0 0 su ch p e titio n s f i le d , s te a lin g an d m is c h ie f w ere leading types*

In fo rm a l d is p o s itio n was re lie d upon i n o n ly a r e l a t i v e l y

small p ro p o rtio n o f th e c a s e s : adjustm ent.

342 were re fe rre d t o o t h e r a g e n c ie s f o r

A lthough no confirm ation could be o b tain ed from th e a n n u a l

re p o rt, over 1 ,1 0 0 y o u n g s te rs were reported to be r e f e r r e d f o r d i a g n o s t i c c lin ic a l s t u d i e s and presum ably another 800 fo r p s y c h o lo g ic a l t e s t i n g only* I t was a s s e r te d , t o o , t h a t 361 were receiving p s y c h ia tr ic tr e a tm e n t o f a reg u lar n a tu re u n d e r j u v e n i l e c o u rt auspices, bu t w ith t h e f a c i l i t i e s a v a i l ­ able i t was r a t h e r h a rd f o r th e in v e stig a to r to see j u s t how su ch a l a r g e number o f c a s e s c o u ld r e c e iv e anything reasonably re s e m b lin g a d e q u a te and continued p s y c h o th e ra p e u tic s e rv ic e s .

One d iffe re n c e was n o te d i n t h e

f a c i l i t i e s o f New Haven and H a rtfo rd .

The H artford j u v e n i l e c o u r t w as

provided w ith th e s e r v i c e s o f a part-tim e c lin ic a l s t a f f th ro u g h t h e Bureau of M ental H ygiene*

The New Haven u n it i s more d e p en d e n t on com­

munity reso u rce s* F a c i l i t i e s f o r m en tal hygiene, casework and o t h e r a s s i s t a n c e i n the community a r e g e n e r a lly lim ite d , but the 1,900,000 r e s i d e n t s o f Con­ n e c tic u t cannot b e s a i d t o be liv i n g in a "blighted a re a * "

The B u re a u o f

Mental Hygiene o f th e s t a t e Department of Health p ro v id e s a num ber o f c lin ic s and v a rio u s com m unities have th e ir own c h ild g u id an c e c e n te r s * In a d d itio n , h o s p i t a l o u t - p a t i e n t c lin ic s are a v a ila b le and p r i v a t e p r a c t i ­ tio n e rs of p s y c h ia tr y an d psychology can be consulted by th o s e who h av e the means*

As f a r a s p ro v id in g serv ices f o r th e c o u r t , d i a g n o s t i c s t u d i e s

164 can b e done a f t e r some d e la y b u t u s u a l ly i n a b o u t two weeks.

Fees ranging

from $7*50 t o $ 2 5 .0 0 a r e p a id t o p r i v a t e p r a c t i t i o n e r s who a s s i s t the c o u rt.

Through th e y e a r , how ever, th e s e f e e s p ro b a b ly do n o t mount up

v e ry h ig h s in c e t h e c o u r t has no p la n s f o r m a in ta in in g fu ll- tim e c lin ic s e n t i r e l y u n d e r c o u r t a u s p ic e s .

I n th e ab sen ce o f such c li n i c s , n a tu ra lly ,

n o t a l l y o u n g s te rs have th e b e n e f i t o f c l i n i c a l s tu d y o r observation, and no s c re e n in g p la n i s i n o p e ra tio n w hich would f u n n e l o f f those cases most B e rio u s ly n e e d in g such s p e c ia liz e d a s s i s t a n c e .

When c l i n i c a l re fe rra ls

a r e made by th e ju d g e o r p ro b a tio n s t a f f , r e p o r t s a r e subm itted which seem g e n e r a lly fo llo w e d — a lth o u g h th e ju d g e i s th e f i n a l a p p ra is e r of c lin ic a l and p r o b a tio n recom m endations. The i n v e s t i g a t o r 's s u b je c tiv e im p re ss io n o f th e Connecticut services was c o lo re d by h i s f e e l i n g a b o u t t h r e e w eak n esses.

Though no large number of

y o u n g s te rs had to b e d e ta in e d i n th e d i s t r i c t c r a t e r s , and even considering t h a t th e b u d g e ta ry allo w an ce f o r d e ta in in g c h ild r e n was undoubtedly rath er m eag er, th e d e te n tio n program seemed t o be q u i t e l i m i t e d .

•*

The children

a r e q u a rte r e d i n th e j u v e n i l e c o u r t b u i l d i n g , and th e sm all number of per­ so n n e l b o th i n th e Second and th e T h ird D i s t r i c t s seemed to leave very l i t t l e p r o v is io n f o r a p r o g r e s s iv e , a l l y e a r , around th e clook service. (W hile n o t v i s i t e d , t h i s would seem t o a p p ly even more so in Bridgeport). As a m a tte r o f f a c t , one o f th e problem s m entioned by th e D irector of Pro­ b a ti o n i n H a rtfo rd was th e need f o r a s t u d / home f o r y o u n g ste rs in which th e y m ight b e s u i t a b l y o b se rv e d .

I n a d d i t i o n , th e I n v e s tig a to r f e l t th at

a lth o u g h c l i n i c a l f a c i l i t i e s a r e n o t a s m eager a s th e y a re In certain other

*

W hile th e o b s e rv a tio n was b r i e f end th e i n c i d e n t may have been an iso­ l a t e d o n e , th e I n v e s t i g a t o r was d is tu r b e d by th e s ig h t of youngsters on a c le a n -u p d e t a i l — w hich seemed somehow a t v a ria n c e with the aim s o f h e lp in g , s tim u la tin g and r e - e d u c a tin g th e c h ild re n .

165 s ta te s , th e y were q u i t e lim ite d especially in th e p r o v is io n o f o u t - p a t i e n t psychotherapy*

F i n a l l y , throughout, a sense of t h e u rg e n c y o f a p r e v e n t iv e

emphasis a p p eared t o b e la c k in g . On th e o t h e r hand, several high sp o ts i n th e work o f t h e C o n n e c ti­ cut ju v e n ile c o u r t a p p e a re d In reference to c o u rses w hich th e c o u r t h ad sponsored i n c o n n e c tio n w ith Tale U niversity some y e a r s b e f o r e and a l i t t l e p u b lic a tio n , The J u c o n . devoted to phases o f ju v e n ile c o u r t w ork, p e r i o d i ­ c a lly p u b lis h e d by th e c o u r t. Boston The h i s t o r i c a l l y im portant c ity o f B oston, a l a r g e m a n u fa c tu rin g center and p o r t o f e n t r y was reported as f i r s t s e rv e d by a j u v e n i l e c o u r t in September 1906.

A c tu a lly , g reater Boston w ith i t s p o p u la tio n o f o v e r

770,000 h a s more th a n a s in g le juvenile co u rt s in c e Cambridge h a s one o f i t s own.

The j u v e n i l e c o u rt refe rred to in the l i t e r a t u r e h a s a s e r v i c e

area o f a b o u t 300,000 p e o p le .

For th ese, i t h e a rs d e lin q u e n c y p e t i t i o n s ,

n eg lect p e t i t i o n s and s e rv e s a lso in the a d ju d ic a tio n o f c a s e s i n v o lv in g ad u lts f o r c o n tr i b u ti n g t o th e delinquency o f m inors o r f o r n e g l e c t i n g them.

The j u r i s d i c t i o n o f th e court i s exclusive e x c e p t f o r a p p e a ls w hich

may be c a r r i e d to t h e S u p e rio r Courts. F o r 194-7, a t o t a l o f 664 cases were seen a t i n ta k e o f w hich 561 were d elin q u en cy p e t i t i o n s .

According to th e c h i e f p r o b a tio n o f f i c e r t h e s e

cases were a ll, a d ju d ic a te d r a th e r than re fe rre d t o community a g e n c ie s .

To

round out th e s t a t i s t i c a l p ic tu r e of the work o f th e c o u r t , a n a n n u a l r e ­ p o rt was re q u e s te d d u rin g th e f ie ld t r ip end a g a in i n c o n n e c tio n w ith t h e q u e stio n n a ire su rv e y .

None could be obtained, en d a s a r e s u l t , th e view

of t h is a s p e c t o f f u n c tio n in g i s very sketchy.

F ig u re s on t h e num ber o f

youngsters se en f o r d ia g n o s tic stu d ies, p sy c h o lo g ic a l t e s t s o r c a r r i e d i n

166 tr e a tm e n t w ere n o t s u p p lie d .

R eference was made, however, to the report

o f t h e C i ti z e n s h ip T ra in in g D epartm ent w hich, w h ile d e scrip tiv e , affords l i t t l e i n t h e way o f q u a n t i t a t i v e in fo rm a tio n .

I t appears, however, th at

a l l b o y s b etw een th e ag es o f tw elve and se v e n te e n (th e upper age lim it of c o u r t j u r i s d i c t i o n ) who a r e p la c e d on p ro b a tio n a r e assigned to the C iti­ z e n s h ip T r a in in g D epartm ent.

I t was a s s e r te d t h a t boys over twelve of

a v e ra g e i n t e l l i g e n c e were so h a n d le d , b u t t h e r e i s no indication th at these i n t e l l i g e n c e a p p r a i s a ls were a n y th in g o th e r th a n su b je ctiv e evaluations by t h e ju d g e o r by members o f th e p ro b a tio n s t a f f . From th e Judge B aker Guidance C e n te r, though, i t was learned th at d u r in g 194-7, a t o t a l o f 89 y o u n g s te rs o f th e C itiz e n s h ip Training group w ere s e r v e d .

Even assum ing t h a t o th e r re s o u rc e s a re available end are

u t i l i z e d b y t h e c o u r t , s t i l l , th e B oston j u v e n i l e c o u rt which through i t s i d e n t i f i c a t i o n w ith th e Judge B aker C en ter a c q u ire d considerable recogni­ t i o n i n t h e l i t e r a t u r e f o r th e i n te g r a t i o n o f p s y c h ia tr ic services in the tr e a tm e n t o f y o u th f u l o ffe n d e rs seems a t p r e s e n t t o be quite poorly sup­ p l i e d w ith c l i n i c a l s e r v ic e s . Among th e re s o u rc e s w hich th e j u v e n i l e c o u rt can draw upon be­ s i d e s t h e Ju d g e B aker Guidance C e n te r, a re th e C a th o lic Boys1 Guidance C e n te r , t h e B o sto n P sy ch o p a th ic H o s p ita l, th e C h ild re n 's Center and the H a b it C l i n i c f o r C h ild G uidance.

A nother h o s p i t a l (Metropolitan State)

and th e S o u th a rd C lin ic a r e a v a i la b l e a lo n g w ith a v a rie ty of more general community s e r v i c e a g e n c ie s .

In th e o p in io n o f th e c h ie f probation o ffic e r,

th e f a c i l i t i e s l i s t e d a r e a d eq u a te n o t o n ly f o r community needs but to m eet th o s e o f th e ju v e n ile c o u rt a s w e ll.

C l in i c a l services were char­

a c t e r i z e d a s s a t i s f a c t o r y s in c e i t was r e p o r te d t h a t diagnostic examina­ t i o n s c o u ld b e a rra n g e d w ith o u t d e la y and presum ably therapy could be

107 i n i t i a t e d w ith in te n days*

This view of th e adequacy o f community r e s o u r c e s

and th e speed w ith which the juvenile court can b e s e rv e d i s s h a r p l y a t v a r i ­ ance w ith th e more d e ta ile d statement fu rn ish e d b y th e Judge B a k er G uidance C e n te r, however*

I n l i n e with the opinion e x p re s s e d , th o u g h , t h e r e was no

in d ic a tio n t h a t an expansion of court c lin ic a l, s e r v i c e s i s c o n te m p la te d . When c l i n i c a l consultations a re p ro v id e d , t h e r e a p p e a rs t o b e l i t t l e ev id en ce t h a t recommendations are re g a rd e d a s a n y th in g more th a n advisory*

H ot o n ly i s th ere no provision f o r p s y c h i a t r i c and p s y c h o lo g ic a l

s e rv ic e s f o r each c h i l d , no screening plan e x i s t s t o a s s u r e even b r i e f c l i n i c a l c o n s u lta tio n s p r io r to disposition*

Even i f th e C i ti z e n s h ip Train-*

ing group does p ro v id e each youngster p a r t i c i p a t i n g w ith an o p p o r tu n ity f o r c l i n i c a l o b s e r v a tio n , i t should be borne in mind t h a t t h e s e c o n ta c t s a r e only a ff o rd e d th o s e boys whose cases have a lre a d y been d is p o s e d o f by t h e c o u rt and who have been placed on probation*

T h is a p p e a rs t o b e a s e r i o u s

flaw from th e p o in t o f view of enlightened j u v e n i l e c o u r t o p e r a t io n . C e r ta in ly th e fea tu re of the Boston ju v e n i l e c o u r t program i s i t s C itiz e n s h ip T ra in in g Department.

Supported by g r a n ts from th e G r e a te r

Boston Community Fund and other private s o u rc e s , i t f u n c t i o n s u n d e r t h e judge o f th e ju v e n ile c o u rt,

i t i s sta ffe d by a d i r e c t o r , c a s e w o rk e rs ,

*

a p s y c h ia tris t,

p a r t- tim e teachers and a s e c r e t a r y .

On b e in g p la c e d on

p ro b a tio n by th e ju v e n ile court boys from tw elv e t o s e v e n te e n r e p o r t t o the D epartm ent f o r tw elve weeks, five days a week f o r two a f t e r - s c h o o l h o u rs.

C e n tered i n th e Young Men's C h ristia n Union b u i l d i n g , b e s i d e s o f ­

f ic e and c l a s s sp a c e , re c re a tio n a l f a c i l i t i e s a re a v a i l a b l e .

*

In a d d itio n ,

T his p s y c h i a t r i s t seems to serve in the c a p a c ity o f a c o n s u l ta n t r a t h e r th a n on a f u l l - t i m e b a sis.

168 a m e d ic a l s e r v ic e I s p ro v id e d a lo n g w ith a c e r t a i n amount of psychological t e s t i n g (w hich does n o t a p p e a r t o b e vexy e x te n s iv e in n a tu re ).

A so cial

i n v e s t i g a t i o n i s co n d u cted , in te r v ie w s a r e h e ld w ith the boy, and group a c t i v i t i e s in c lu d in g p h y s ic a l t r a i n i n g , cla ssro o m discussions and movies ta k e p la c e .

A r e p o r t t o th e c o u r t i s su b m itte d and the probation s ta f f

i s e n tr u s te d w ith c a r r y in g o u t t h e s te p s o f w hatever projected follow-up p ro g ra m i s d e c id e d upon. S e v e ra l obv io u s a d v a n ta g e s i n t h i s system of operation were noted by th e in v e s tig a to r.

P a r t i c i p a t i o n does n o t i n te r f e r e with school attend­

a n c e and need n o t d i s r u p t th e c h i l d 's l i f e t o any great ex ten t.

The atmos­

p h e r e o f r e t r i b u t i o n and p u n itiv e n e s s i s c le a r e d somewhat by the clu ste rin g o f a c t i v i t i e s i n th e B oston "11

F u r th e r , th e group settin g can be used

c o n s t r u c t i v e l y s i n c e , a s i n c e r t a i n th e r a p e u tic approaches, the youngster d e r i v e s some s u p p o rt from o th e r c h ild r e n going through the program with him. On th e d e b i t s i d e , th e i n v e s t i g a t o r wonders what happens to those y o u n g s te r s who, w ith o u t c l i n i c a l c o n s u l ta ti o n , a re destined fo r commitment r a t h e r th a n p r o b a tio n .

Not a l l r e c i d i v i s t s , such children would presum­

a b l y m is s th e o p p o rtu n ity f o r such a s s i s t a n c e a s th e Citizenship program w o u ld a f f o r d .

I t i s t o be hoped t h a t th e o p e ra tio n of the Youth Act newly

i n e f f e c t i n th e s t a t e o f M a ssa c h u se tts w i l l make up fo r these and other d e fic ie n c ie s . The Ju d g e B aker G uidance C en ter O p e ra tin g s in c e 1917, th e C e n te r i s a p riv a te ly endowed and com­ m u n ity C h e st-su p p o rte d o r g a n iz a tio n .

There i s a c t iv i t y directed n o t only

t o f o s t e r i n g a d ju s tm e n t o f th e c a s e lo a d , b u t according to the annual re ­ p o r t on a l o c a l , n a t i o n a l a s w e ll a s i n t e r n a t i o n a l scale.

Training pro­

gram s i n c l i n i c a l f i e l d s , re s e a rc h and community education are also

169 conceived o f w ith in the scope of the C enter's a c t i v i t i e s . The o p e ra tin g personnel in clu d es b o th r e g u la r s t a f f members a n d w orkers i n t r a i n i n g .

In a l l , the Center b o a s t s a l a r g e r p r o f e s s i o n a l s t a f f

th an any o f th e c o u rt c lin ic s studied.

They w ere a b le t o s e r v e , d u r i n g

194-7, o v e r l y300 youngsters (or parents) and an a d d i t i o n a l 89 r e f e r r e d by th e C itia e n s h ip T rain in g Department.

The m ost s i g n i f i c a n t f a c t i n t h e i r

o p e ra tin g s t a t i s t i c s was the s tre s s not on d i a g n o s ti c b u t r a t h e r on t r e a t m e n t s e rv ic e s .

W hile th e sum to ta l of a l l c o n ta c ts w ith p a t i e n t s w ould n o t a llo w

f o r a v e ry g r e a t p ro p o rtio n of the t o ta l c a s e lo a d t o h e c a r r i e d i n i n t e n s i v e th e r a p y , th e work o f the Center departs from th e o n e - v i s i t a p p r a i s a l o f t h e problem c h i l d . A lthough th e Center i s ap p aren tly s h o r t o f p s y c h o l o g is ts b y c u r ­ r e n t l y a c c e p te d sta n d a rd s, the team concept o f a c t i v e c o l l a b o r a t i o n seem s t o b e g e n e r a lly a p p lie d .

Court cases, how ever, r e c e iv e n o t much m ore th a n

d ia g n o s tic s e r v ic e , and in general the tim e -la g betw een t h e b o o k in g a n d k e ep in g o f an appointm ent runs about th re e m onths e x c e p t f o r e m e rg e n c ie s . I t i s f e l t t h a t th e recommendations embodied i n th e c o u r t r e p o r t a r e gen­ e r a l l y fo llo w e d and t h a t re la tio n s with th e p r o b a tio n s t a f f a r e good* B ro ad er community p a rtic ip a tio n in t r e a tin g t h e problem c h i l d on an o u t ­ p a t i e n t b a s i s a p p e a rs to be lim ited , however. In a c t i v i t i e s going beyond case c o n ta c t s , some r e s e a r c h in co n n ec­ t i o n w ith s tu d e n t th e s e s was mentioned a lo n g w ith a s e r i e s o f p u b l i c a t i o n s by s t a f f members some of idiom serve also i n a te a c h in g c a p a c ity a t l o c a l u n iv e rs itie s .

In i t s public re la tio n e w ork, em phasis i s p la c e d on t h e p r e ­

v e n tio n o f m en tal d ise a s e rather than o f ju v en ile d e lin q u e n c y . A lthough th e C en ter o c c u p ie s a f a i r l y large p riv a te b u i ld i n g , one o f t h e b i g p ro b le m s im peding i t s f u n c tio n in g rig h t now i s th e r e l a t i v e l i m i t a t i o n o f s p a c e .

170 The le n g th y w a itin g l i s t w hich o c c a s io n s t h e lo n g delay before rendering of s e r v i c e i s a n o th e r s o u rc e o f d i f f i c u l t y • I n t h e t h e r a p e u t i c work o f t h e agency a l l profeseion&l s ta f f mem­ b e rs p a rtic ip a te s m ent o b t a i n s .

even s o , th e f a m i l i a r p a t t e r n of an hour a week fo r t r e a t ­

A lth o u g h f o u r o f t h e p s y c h i a t r i c s t a f f members including the

two D i r e c t o r s o f t h e agency a r e p r a c t i c i n g psy ch o an aly sts, th ere seems to be no f i x e d o r i e n t a t i o n p e rv a d in g t h e tr e a tm e n t p ro c e ss .

Bather, group therapy,

n o n - d i r e c t i v e c o u n s e lin g , a b b re v ia te d p sy c h o a n a ly s is , among oth ers are repre­ s e n te d i n th e work o f t h e c l i n i c .

I n f o llo w in g these approaches, non-direc­

t i v e i n t e r v i e w s , f r e e a s s o c i a t i o n , a v a r i e t y o f play techniques, and even sex i n s t r u c t i o n and e d u c a tio n a l te c h n iq u e s a r e employed.

The treatm ent process i s

c h a r a c t e r i s e d a s a im in g a t m o d e ra te ly i n t e n s i v e probing and a id with person­ a l i t y p ro b le m s.

I n th e p r o c e s s , th e e x e c u tiv e se cre tary rep o rts th a t the par­

e n t s o f c h il d r e n i n tr e a tm e n t a r e g iv e n th e same number of interview s as the c h i l d , b u t c o n firm a tio n on t h i s p o i n t was n o t a v a ila b le in the annual re p o rt. I f t h i s i s s ta n d a r d p r a c t i c e , d e s p i t e th e a p p a re n t absence of a sa tisfa c to ry fo llo w - u p program , t h e C e n te r seems t o b e d o in g important work with the f a m ily a s th e f o c u s o f i n d i v i d u a l p a th o lo g y * As f o r t h e work o f t h e c l i n i c a l p sy c h o lo g is ts , the Center seems to h av e ta k e n im p o r ta n t s t r i d e s away from t h e i r u t i l i z a t i o n merely as psychom e tric ia n s .

I n te r v ie w in g and t h e r a p e u t i c w ork, p a rtic ip a tio n in s t a f f con­

f e r e n c e s and p e rs o n n e l t r a i n i n g ta k e up th r e e - q u a r te r s of th e ir tim e. a s m a ll f r a c t i o n o f t h e rem a in d e r i s r e l e g a t e d to te s tin g . g i s t s do p s y c h o th e ra p y u n d e r s u p e r v is io n

*

Only

S ta ff psyeholo-

and themselves supervise psycho-

* T h is u s e o f n o n -m e d ic a l p e rs o n n e l a s p s y c h o th e ra p is ts i s by no means ex­ c l u s i v e w ith t h e C en ter* The New Y ork Regional O ffice o f the V eterans1 A d m in is tr a tio n an d t h e Je w ish B oard o f G uardians, p a rtic u la rly , might b e m e n tio n ed among t h e num erous a g e n c ie s using nan-medical th e ra p is ts who work u n d e r c lo s e s u p e rv is io n * (S o u rc e : Personal observations and Gordon H a m ilto n , P arcfcgth erap y JLu. C h ild ftllfr n g fi).

171 /

l o g i c a l tr a i n e e s i n te stin g work.

No fo rm al b a t t e r y i s em ployed, b u t beyond

an in d iv id u a l in te llig e n c e t e s t, Rorschach and T hem atic A p p e rc e p tio n t e s t s a r e s a id t o be used frequently in a d d itio n t o o t h e r i n d i c a t e d m e a su re e . The conditions of employment o f s t a f f p s y c h o lo g is ts s e e n q u i t e s a t ­ i s f a c t o r y — i f n o t b e tte r than those o f p s y c h o lo g is ts i n th e o t h e r a g e n c ie s s tu d ie d .

Although pressed by a f a i r l y heavy c a s e lo a d , r e g u l a r s t a f f members

have a f a i r l y s h o r t work week end s t i l l r e c e iv e s a l a r i e s c o rre s p o n d in g c lo s e ly t o th e median fo r a l l agencies r e p o r tin g .

Though w ith o u t t h e ad v an ­

ta g e o f te n u r e , funds fo r these p o s itio n s ap p ea r re a s o n a b ly s e c u r e .

In a l l ,

th e w orking co n d itio n s of the Center a p p e a r t o be co n d u civ e t o p e rfo rm in g c o n s tr u c tiv e psychological serv ice s.

I f c o n d itio n s a t t h e Judge B a k e r

Guidance C enter axe, froa the p o in t o f view o f o p e r a tin g p e rs o n n e l, l e s s s a t i s f a c t o r y th an th is evaluation would s u g g e s t, h a n d ic a p s w ere n o t v e r y a p p a re n t i n th e tim e available f o r p e rs o n a l o b s e r v a tio n s .

jtap rgB eatettyi figurt

Counter C lia ls

Newark i s a c ity which with i t s e n v iro n s h a s a c u r r e n t p o p u la tio n o f ab o u t 950,000.

A major seaport, an I n d u s t r i a l and m a n u fa c tu rin g c e n t e r ,

i t i s se rv e d by a juvenile court, which w h ile i t d o e s n o t m a in ta in a c l i n i c o f i t s own, has f a i r l y fre e access to a c o u n ty -s u p p o rte d c h il d g u id a n c e s e rv ic e . Newark The c o u rt serving the c ity o f Newark i s o r g a n is e d a s a j u v e n i l e and dom estio re la tio n s unit*

The o r i g in a l a c t u n d e r w h ich ju v e n i l e s w ere

sp ared a d u l t crim in al treatm ent goes back a b o u t f o r t y - s e v e n y e a r s .

A t p re ­

s e n t, th e c o u rt spends some 50# o f i t s tim e on j u v e n i l e c a s e s and t h e re m a in ­ d e r on fa m ily problems.

Exclusive J u r i s d i c t i o n i s e x e r c is e d o v e r c h i l d r e n

up to e ig h te e n y e a rs of age.

172 Q u a n t i t a t i v e l y , d u rin g 19X7, 1 ,6 8 1 children alleged to be delinquent w e re se en a t i n t a k e .

Of t h e s e , 1 ,4 7 9 w ere adjudicated — almost 88jf.

Only

202 y o u n g s te rs w ere h a n d le d e n t i r e l y in fo rm a lly through the o ffice o f a s p e c i a l p r o b a tio n w o rk e r.

I n a l l , i t i s estim ated th a t about one-third of

t h e c a s e s w ere o f t h e f a m i l i a r b re a k in g and entering v a rie ty with immorality a n d i n c o r r i g i b i l i t y fo llo w in g i n o r d e r o f frequency.

Besides delinquency

p e t i t i o n s , a c t io n s in v o lv in g n e g le c t and m ental deficiency also were handled. Of th e t o t a l num ber o f c a s e s s e e n , i t was estim ated th a t 100 young­ s t e r s i n a l l w ere g iv e n d ia g n o s tic s t u d i e s .

Further, no more than ten were

c a r r i e d i n tr e a tm e n t, b u t i t i s n o t e n t i r e l y c le a r ju s t what resources were a v a i l a b l e t o p ro v id e p sy c h o th e ra p y u n d e r c o u rt auspices on a regular b a sis. Among tr e a tm e n t f a c i l i t i e s l i s t e d w ere th e Essex County Juvenile C linic which t h e c le ric o f c o u r t i n d i c a t e d i s h e a v ily r e l i e d upon.

In addition, the Essex

C ounty H o s p ita l, and C ity H o s p ita l o f Newark are available fo r in -p a tie n t s e rv ic e s .

O c c a sio n a l d ia g n o s tic d a ta a r e furnished by the Board of Education,

a n d one tr e a tm e n t r e s o u r c e i s th e J e w is h C hild Guidance C linic which i s s e l e c t i v e i n i n ta k e s in c e i t i s a denom inational service. The a t t i t u d e tow ard c l i n i c a l s e rv ic e s i s re fle c te d in the appraisal o f d i a g n o s ti c f a c i l i t i e s a s a d e q u a te , b u t treatm ent resources as poor. T h ere i s no a p p a re n t d i f f e r e n c e , e i t h e r , i n the a v a ila b ility of c lin ic a l s e r v i c e s f o r d e lin q u e n ts a s compared w ith nan-delinquent children.

The

ti m e - l a g betw een t h e r e q u e s t and a c l i n i c a l appointment was estim ated as tw o weeks more o r l e s s and th e g e n e r a l a t t i t u d e i s th a t services of the c o u n ty c l i n i c a r e s a t i s f a c t o r y f o r th e c o u r t.

There are no plans fo r a

c l i n i c a tta c h e d t o t h e c o u r t . Not o n ly does t h e Newark c o u rt f a i l to provide c lin ic a l services f o r bach o f i t s y o u n g s te rs p r i o r t o d is p o s itio n , even a screening arrange-

173 raent f o r d e te c tio n of the c lin ic a lly more se v e re c a s e s i s l a c k i n g .

I t ic

r e p o r te d , however, th a t a t the now o v e rta x e d co u n ty d e te n tio n f a c i l i t y , a p s y c h ia tr ic s o c ia l worker sees each y o u n g ster*

However, th e h u lk o f c a s e s

a p p ea rin g b efo re the court are o r d in a r ily n o t d e ta in e d , so t h a t even t h i s c o n ta c t i s n o t afforded.

C lin ic a l r e p o r t s and recom m endations a r e c o n s id e r e d

t o b e u s u a lly accepted by the judge i n whose hands th e d i s p o s i t i o n o f t h e p e t i t i o n re s ts * A couple of ites8 of i n t e r e s t n o te d i n th e annual, r e p o r t may a l s o b e m entioned.

Judge Lindeoann c a l l s a t t e n t i o n t o th e la c k o f a v a i l a b l e

f o s t e r hones and in addition to th e need f o r f i n a n c i a l a id from p r i v a t e so u rc e s t o send children to s p e c ia l sc h o o ls and fa rm s .

More p o s i t i v e l y ,

E ssex County has encouraged the o r g a n is a tio n , r e l a t i v e l y r e c e n t l y , o f s e v e r a l M unicipal Youth Guidance C ouncils d e sig n e d t o s tim u la te w ork o f a p re v e n tiv e n a tu re , E ssex County Juvenile Clinic T his c lin ic is f a ir ly w e ll known a s t h a t w ith w hich D r. Jam es S . P la n t was id e n tifie d u n til h is r e c e n t d e a th .

O p e ra tin g f o r tw e n ty y e a r s i n

a sm all b u ild in g not too f a r away from th e ju v e n ile c o u r t , a p p ro x im a te f i g u r e s f o r 1949 (rather than 1947) show t h a t a b o u t 43% o f i t s c a s e s w ere r e f e r r e d by th e juvenile court (and a n o th e r 18% b y t h e Newark s c h o o ls )* To se rv e a caseload of about 500, a sm a ll s t a f f i s a v a i l a b l e on f u l l - t i m e b a s is .

In f a c t , only recently th e p r o f e s s io n a l team re c e iv e d an ad d ed

a llo tm e n t f o r psychiatric case work a s s i s t a n c e b u t i s hampered b y s t a f f v a c a n c ie s .

* The i n i t i a l request for figures in th e q u e s tio n n a ir e m et w ith l i t t l e success* On the fie ld t r i p , how ever, more e x a c t d a ta w ere ob­ ta i n a b l e .

174 The c l i n i c i s c l e a r l y i d e n t i f i e d by the D irector as a diagnostic s e r v ic e a lth o u g h th e c o u r t seems t o co n sid er i t a lim ited treatm ent source* The team a p p ro a c h t o c a s e s i s employed i n perhaps 60$ of those Been a t the c lin ic .

On a v e ry s u b s t a n t i a l p o r t io n o f th ese, so c ial work or case h isto ry

d a ta and p s y c h o lo g ic a l in fo r m a tio n may be furnished by cooperating agencies* The c l i n i c i s n o t e q u ip p e d , a c c o rd in g t o the D irector to provide q u ite the prom pt s e r v i c e a s s e r t e d by th e c l e r k o f courts in v o lv e d b e f o r e a d ia g n o s ti c stu d y can b e made* s t u d i e s a r e em bodied i n a r e p o r t t o th e court*

ra th e r a six-week w ait i s The completed diagnostic The recommendations, the

D i r e c t o r f e e l s a r e u s u a lly fo llo w e d by th e court and presumably imple­ m ented by t h e p r o b a tio n s t a f f s in c e a good working rela tio n sh ip e x is ts . Some d i f f i c u l t i e s i n th e way of providing an e ffe ctiv e service of t h e even l i m i t e d n a t u r e u n d e rta k e n by th e c lin ic grows out of the f a c t th a t t h e community p l a y s r e l a t i v e l y l i t t l e p a r t in helping the youngsters to make b e t t e r a d ju stm e n t*

F a c i l i t i e s f o r b o th o u t-p a tie n t and in -p a tie n t care of

i n d i v i d u a l s w ith e m o tio n a l p ro b lem s a re q u ite inadequate*

Moreover, fo s te r

homes o f a s a t i s f a c t o r y s o r t a r e d i f f i c u l t to lo ca te and In s titu tio n a l p la c e m e n ts o f f e r i n g p s y c h i a t r i c f a c i l i t i e s are in very short supply* C h ild re n in v o lv e d i n s e x u a l p ro b lem s a re esp ecially d if f ic u lt to a id — p a r tic u la r ly th e g i r l s . O th e r h a n d ic a p s i n t h e way o f providing maximal service grow o u t o f th e f a c t t h a t th e c l i n i c l a c k s s u ffic ie n t sta ff*

In p a rt, fo r

t h a t r e a s o n , no r e s e a r c h i s i n p r o g r e s s a t the c lin ic and no tra in in g is u n d e rta k e n b y members o f th e c l i n i c s t a f f .

The major work of a preventive

n a tu r e a lo n g p u b l ic r e l a t i o n s l i n e s i s occasional ta lk s by the Director* P r o s p e c ts f o r th e f u t u r e do n o t a p p e a r p a rtic u la rly b rig h te r since no ex­ p a n s io n o f t h e c l i n i c i s c o n te m p la te d and the need fo r services does not a p p e a r t o be d e c lin in g *

175 The work of the p sy c h o lo g is t l a t h i s u n i t f o c u s e s l a r g e l y on i n ­ te llig e n c e te stin g , achievement t e s t i n g , and th e w r itin g o f r e p o r t s . 50%

o f th e p sychologists tim e i s th u s o c c u p ie d .

A bout

A d d itio n a l tim e i s s p e n t

i n some "b rie f therapy," p u b lic r e l a t i o n s w ork, and t o a s l i g h t e x t e n t i n c l e r i c a l d u tie s.

S ig n ific a n tly , th e i n v e s t i g a t o r was t o l d t h a t t h e p r e s e n t

s t a f f member is not fam iliar enough w ith s ta n d a r d p r o j e c t i v e te c h n iq u e s f o r th e s e t o be regularly employed.

The te n c a s e s doneweekly by t h e p s y c h o l o g is t

a r e divided as half-tim e i s devoted to s e r v ic e f o r th e s c h o o ls an d t h e b a l ­ ance f o r the clinic*

No s a la ry l e v e l f o r t h i s p o s i t io n was i n d i c a t e d , b u t

i t i s a fu ll-tim e job and presum ably pays l e s s th a n $ 4 ,0 0 0 .

As i t was o u t­

lin e d , th e position seems below th e l e v e l o f r e s p o n s i b i l i t y o f t h e f u l l y tr a in e d c lin ician . Certain general s u b je c tiv e r e a c t i o n s t o c o n d itio n s i n Newark may b e expressed in the in v e s tig a to r 's f e e l i n g , a l b e i t somewhat f l i p p a n t l y , t h a t children should n e ith e r develop a n e u r o s is n o r become d e lin q u e n t t h e r e . The school has one diagnostic u n i t . same.

The E ssex County C l in i c d o e s much th e

There is a mental hygiene c l i n i c o f a l o c a l h o s p i t a l open t o p a t i e n t s

over six teen years of age.

One genuine tr e a tm e n t re s o u r c e i s d e n o m in a tio n a l.

F o r young children who are n o t com raitable a c t u a l tr e a tm e n t r e s o u r c e s a r e g ra v e ly inadequate. R epresentative Court with P sychiatrA c C lin ic The Westchester County J u v e n ile C ourt was s e l e c t e d a s r e p r e s e n ­ t a t i v e of those courts which m a in ta in t h e i r own p s y c h i a t r i c c l i n i c . W estch ester County The juvenile c o u rt s e rv in g W e stc h e ste r County b e g an o p e r a tio n i n 1922 and though located p r in c ip a lly i n W hite P l a i n s , s e r v e s a l s o th e com-

176 m uni t i e s o f Y o n k e rs, Mount Vernon and New Rochelle.

Besides being import­

a n t su b u rb s o f New York C i t y , th e s e c it i e s in t h e i r own rig h t are manufac­ t u r i n g an d i n d u s t r i a l c e n t e r s on a sm aller sc a le .

The serv ice area of the

c o u r t em braces & p o p u la tio n o f alm ost 600,000 and o rig in a l ju ris d ic tio n in t h e c o u n ty i s e x e r c i s e d .

A d o m estic re la tio n s co u rt, the caseload includes

b e s i d e s f a m i l i a r d e lin q u e n c y and n e g le ct a c tio n s , actions of non-support, p e t i t i o n s in v o lv in g p a t e r n i t y and out-of-vedlock children, as v e il of th o s e o f h a n d ic a p p e d y o u n g s te rs * D u rin g 1 9 4 7 , o f a t o t a l of a l i t t l e more than 1,000 cases a t in ­ t a k e , 638 in v o lv e d a l l e g e d d e lin q u e n ts .

S ig n ific a n tly , th e c le rk of oourt

a d v is e s t h a t 382 o f t h e s e w ere handled inform ally.

An a d d itio n a l number

(3 5 ) w ere d is m is s e d , c lo s e d o r withdrawn, leaving only 171 to be adjudi­ c a te d .

D u rin g t h e same p e r i o d , f u l l diagnostic stu d ies on 150 youngsters

w ere c o n d u c te d .

As f o r a c t u a l p s y c h ia tric treatm ent provided an a reg u la r

b a s i s u n d e r j u v e n i l e c o u r t a u s p ic e s , th ere was none.

The c lin ic served to

r e f e r c a s e s t o s e v e r a l l o c a l tre a tm e n t resources. P ro m in e n tly m en tio n ed among the community mental h e alth f a c i l i t i e s was G ra s s la n d s H o s p i t a l , a c o u n ty cen ter m aintaining a p sy c h ia tric ward. I n a d d i t i o n , t h e r e a r e a v a i l a b l e sev eral county mental hygiene c lin ic s , t h e d i a g n o s t i c s e r v i c e s o f t h r e e c ity school systems, and p riv a te p ra c ti­ tio n e rs .

T hese h av e b e e n a p p ra is e d as being sh o rt of meeting p o te n tia l

n e e d s ev en th o u g h f o r n o n -d e lin q u e n ts f a c i l i t i e s are considered f a ir ly a d e q u a te .

P s y c h o th e r a p e u tic s e rv ic e s f o r young delinquents on a reg u lar

b a s i s hav e b e e n c h a r a c t e r i z e d a s being p ra c tic a lly n i l . The c o u r t c l i n i c , w hich can handle cases in about two o r th ree w eeks a f t e r r e f e r r a l , was s a i d t o provide a c lin ic a l contact f o r each y o u n g s te r p r i o r t o d i s p o s i t i o n .

This a s s e rtio n , however, i s a t variance

177 w ith the fact that over 600 a lle g e d d e lin q u e n ts were se e n a t i n t a k e b u t few er than half of them were se rv ed by th e c o u rt c l i n i c . serv ice for a l l , there i s no s c re e n in g p la n i n o p e r a t io n .

I n th e a b se n c e o f In th o s e cases

where a psychiatric r e f e r r a l I s p ro v id e d i t i s f e l t t h a t t h e r e p o r t s and recommendations submitted a re g e n e ra lly fo llo w ed by th e c o u r t a lth o u g h th e ultim ate disposition r e s t s w ith th e ju d g e .

S u b je c tiv e ly , th e i n v e s ti ­

g a to r carried away no p a r t i c u l a r im p re ssio n s a b o u t th e c o u r t o t h e r th a n t h a t i t seens to have made c o n sid e ra b le p ro g re s s to w ard s th e g o a l o f m axim al inform al handling of delinquency a c t i o n s .

On th e o t h e r h a n d , t h e c l i n i c a l

se rv ice appears to be o f a lim ite d n a tu r e and i s a v a i l a b l e t o a r a t h e r sm all segment of the t o t a l c a se lo a d . Ju v e n ile Coart Clinic The clin ic was o rganized i n 1930 and, f in a n c e d by t h e C ounty o f W estchester, serves th e ju v e n ile c o u rt o n ly .

O p e ra tin g p e rs o n n e l i s sm al­

l e s t in number, with b u t one e x c e p tio n , o f any o f t h e c l i n i c s s t u d i e d . The s ta f f includes a p s y c h i a t r i s t and p s y c h o lo g is t who work h a l f - t i m e .

No

p sy c h iatric social worker i s employed b u t f i f t e e n s o c i a l w o rk e rs c a l l e d probation officers serve th e ju v e n ile c o u r t and p re p a re m a t e r i a l f o r th e c li n i c . A to ta l of 361 c a se s were se rv ed by th e c l i n i c d u rin g 194.7.

Of

th e s e , 249 wan stu d ies done on d e lin q u e n t y o u n g s te rs an d a n a d d i t i o n a l 31 non-delinquents also were se rv e d .

S i g n i f i c a n t l y , 29£ o f t h e c a s e lo a d was

made up of parents, guardians o r a d u lts connected w ith j u v e n i l e c a s e s . The services rendered, however, w ere o f a d ia g n o s tic o r r e f e r r a l n a t u r e only since none of th e p a tie n ts w ere s a id t o be c a r r i e d i n s u s ta i n e d c l i n ­ i c a l treatment.

An e d u c a tio n a l s e r v ic e t o th e p a t i e n t s was m en tio n e d to o ,

b u t the nature of t h i s s e rv ic e was n o t c l a r i f i e d .

178 R e f e r r a l s t o th e c l i n i c are made e ith e r by the judge or supervisory w o rk e rs , b u t th e a s s e r t i o n t h a t a tra in e d c lin ic a l s ta f f member interview s o r exam ines each y o u n g s te r on delinquency p e titio n before d isp o sitio n by the c o u r t seems a g a in a t v a r ia n c e w ith actu al p ra c tic e .

Service by the c lin ic

was s a i d , by th e D i r e c t o r , t o be available to the p a tie n t in about a week and t h e team c o n c e p t was c o n sid e re d to apply ttto an e x te n t."

The a ctu a l ap­

p l i c a t i o n o f c o l l a b o r a t i o n by th re e or four c lin ic a l s p e c ia lis ts i s hard to v i s u a l i z e , th o u g h , i n a s e t t i n g in which a t le a s t one p i l l a r of the c lin ic a l team i s m is s in g . The work o f th e c l i n i c i s usually embodied in a co u rt rep o rt which t h e p s y c h i a t r i s t i n c h a rg e c o n sid e rs e ith e r generally followed by the co u rt, o r u s e d o r n o t — a t th e d i s c r e t io n of the judge.

Implementation of c lin ic a l

s u g g e s tio n s a p p e a re d a id e d by c lo se re la tio n s with the probation s t a f f , but community r e s o u r c e s p r e s e n t a much more clouded p ic tu re .

There seems to be

l i t t l e p a r t i c i p a t i o n by o t h e r community agencies in the c lin ic a l treatm ent f o r y o u n g d e lin q u e n ts (p e rh a p s i n p a r t because o u t-p a tie n t treatm ent f a c i l i t i e s a r e n o t to o am ple) .

F a c i l i t i e s f o r the gravely disturbed a re av aila b le to

t h o s e who can b e c e r t i f i e d a s p sy ch o tic, but not very re a d ily to those whose c o n d it i o n s a r e b o r d e r l i n e o r in c ip ie n t.

Emotional disturbance i s another im­

p e d im en t i n th e way o f p l a c in g those children who req u ire environmental change. As f o r r e a c h in g o u t i n to the community, the c lin ic seems to be ad­ h e r in g c l o s e l y t o i t s s e r v i c e fu n c tio n .

No follow-up work i s undertaken by

members o t h e r th a n th e p r o b a tio n s t a f f .

Research i s not being conducted.

T r a in in g i s e x tre m e ly l i m i t e d — one student from a lo c a l u n iv e rs ity on a s o r t o f f ie ld - w o r k p la c e m e n t b e in g in d ic ativ e of the extent of t h i s phase of c lin ic a c tiv ity .

S i m i l a r l y , l i t t l e i s characterized as being done through

m eans o t h e r th a n c a s e s e r v i c e i n th e preventive work of the co u rt.

179 S ig n ific a n tly , to o , th e q u e s tio n n a ir e on c o u r t p s y c h i a t r i c c l i n i c s e lic ite d no statement o f problem s f a c in g th e c l i n i c . Within th is s e t t i n g , th e c l i n i c a l p s y c h o l o g is t m akes h e r c o n tr i b ­ u tio n primarily as a t a s t e r .

I t i s e s tim a te d t h a t a b o u t

50%

o f p s y c h o lo g i­

c a l time is devoted to i n te l li g e n c e and s c h o o l a c h ie v e m e n t m easu rem en t.

P e r­

haps additional q u a rte r tim e i s d e v o ted t o p e r s o n a l i t y p ro ib in g , w ith th e b a l ­ ance given over mostly to th e w r itin g o f r e p o r t s .

The c l i n i c seem s eq u ip p ed

to use the psychologist as a f u l l y c o n tr i b u ti n g member o f t h e c l i n i c a l team y e t despite the ample range o f t e s t m a te r ia ls a v a i l a b l e , t h e s c h e d u le o f a bout seven cases to be com pleted i n a tw en ty h o u r week seem s t o p r e c lu d e v e ry intensive and q u a lita tiv e study o f th e p a t i e n t .

The a b s e n c e o f even h a lf - t im e

p sy ch iatrically tra in e d s o c ia l w orkers would a l s o a p p e a r t o b e a b a r t o o p e r­ a tio n in the f u ll s p i r i t o f th e c l i n i c a l tea m . For the one p o s itio n o f s t a f f p s y c h o lo g is t i n t h e W e s tc h e s te r u n i t , jo b requirements are p itc h e d r a t h e r h ig h in c lu d in g t h e same s t a t e c e r t i f i c a ­ tio n attestin g to f o r ty - e ig h t academ ic c r e d i t s beyond t h e c o l l e g e g ra d u a tio n and three years of c l i n i c a l e x p e rie n c e a s i s r e q u i r e d i n New T o rk C i ty .

On

an hourly b asis, the s a la ry p a id i s q u ite s a t i s f a c t o r y — h i g h e s t i n f a c t , o f any of the c lin ic s on which d a ta a r e a v a i l a b l e . The impression gained i n th e c l i n i c v i s i t was t h a t i t p e rfo rm s a s t r i c t l y lim ited service — u n d e r p r e s e n t c o n d i t i o n s , f a r m ore r e s t r i c t e d th an would be d e sira b le .

The r a t h e r h ig h p ro p e rtie s # o f work w ith a d u l t s , p a r ­

e n ts and guardians in d ic a te s a w orthw hile t r e n d , h ow ever, w hich m ig h t b e p u t t o even more constructive use i f r e l a t i v e l y n o n - th r e a te n in g g ro u p g u id an c e o r therapeutic sessions could be a rra n g e d . Summary Field study o b se rv a tio n s were made o f courtB and c o u r t c l i n i c a l f a c i l l

180 t i e s i n P ro v id e n c e , Hew Haven, H artford, Boston, Newark and W estchester C ounty.

H ie f in d in g s p a r a l l e l those obtained from the q u estio n n aires.

While

th e j u r i s d i c t i o n and t h e scope of a c tiv ity of the ju v en ile courts have been e x te n d e d , p r o v i s i o n s f o r c l i n i c a l serv ices fo r young delinquents f a l l f a r s h o r t o f w hat m ig h t I d e a l l y be provided.

Although ch ild ren a re n o t spared

fo rm a l c o u r t p r o c e s s in g t o any g reat e x te n t, in those cases which the court u n d e rta k e s t o a s s i s t , f o r la c k of court-m aintained c lin ic s , th ere i s much r e l i a n c e on community f a c i l i t i e s — ch ild guidance and mental hygiene u n its — w h ich a r e th e m s e lv e s o v e rta x e d .

Other treatm ent resources, e sp ec ially where

s u b s t a n t i a l e n v iro n m e n ta l m anipulation i s required are likew ise lim ite d .

Even

th o s e p u b l i c l y s u p p o rte d c l i n i c s which have been provided f o r the ju v en ile c o u r t s p l a y a r e s t r i c t e d r o l e i n the provision of psychotherapy by serving l a r g e l y i n a d i a g n o s t i c , and c o n su lta tiv e capacity. The p i c t u r e i s n o t e n tire ly diBmal, though, since th e f ie ld t r i p y i e l d e d c e r t a i n s ig n s o f a more hopeful n a tu re .

An evident in te r e s t in preven­

t i o n e x i s t s i n P r o v id e n c e , an apparently progressive, p s y c h ia trlc a lly -o rie n ted s p e c i a l program f o r boys on probation has been arranged in Boston.

Of pro­

m is e , t o o , a r e n t h e em phasis on a family approach in W estchester and a t the Ju d g e B ak er G uidance C e n te r which a lso champions a c o n siste n t treatm ent-center­ e d ( r a t h e r th a n d i a g n o s t i c ) approach which may be hoped to s e t a p a tte rn fo r s e r v i c e s p ro v id e d u n d e r c o u r t auspices elsewhere.

CHAPTER V II PARTICIPANT-OBSERVATIONS IN THE PSYCHIATRIC CLINIC OF THE DOMESTIC RELATIONS COURT OF NEW YORK Introduction The in v e s tig a to r w i l l p r e s e n t i n c a p s u le form j u s t a few o f many observations made i n th e c o u rse o f two y e a r s and n i n e m onths o f work a t th e Psychiatric C linic o f th e Domestic R e la tio n s C ourt and d e riv e d a l s o from h i s experiences a t the r e l a te d a g e n c ie s o f G i r l 's Camp and Y outh House a t th e l a t ­ te r of which he has been employed f o r f i f t e e n months* Pre-delinquents From the p o in t o f view o f a p r e v e n tiv e p ro g ram , t h e segm ent o f young­ sters generally r e f e rre d to a s p r e - d e lin q u e n ts a r e s h o r t on community s e r v i c e s . While i t is true t h a t many w e lfa re a g e n c ie s and community g ro u p s a r e co n ce rn ­ ed with the problems o f th e p r e - d e lin q u e n t, a t r u l y p r e v e n t iv e ap p ro ach i s f a r from realizatio n .

One p a r t o f th e netw ork t h a t h a s b e e n c r e a t e d f o r s p o t t in g

and aiding the c h ild whose m aladjustm ent f i n d s e x p re s s io n i n sc h o o l d i f f i c u l t ies is the Bureau o f C h ild Guidance which o p e ra te s a l a r g e l y d ia g n o s tic s e r v ic e fo r the c ity public s c h o o ls.

F o r th e p r e s e n t , how ever, f a c i l i t i e s and p e rso n ­

nel to provide a c tu a l c l i n i c a l tre a tm e n t a r e s e r i o u s l y l i m i t e d , b u t i n t e r p r e t ­ ations and suggestions can a t l e a s t b e o f f e r e d t o t h e te a c h e r s *

A n o th er ad­

vance was marked by th e in tr o d u c tio n o f th e "600" s c h o o ls in te n d e d t o f u r n i s h youngsters who have been u nable t o a d j u s t i n o th e r p u b l ic s c h o o ls , more in d iv id ­ ualized in stru c tio n , guidance and u n d e rs ta n d in g .

Judge D is e r io o f D om estic

182 R e la tio n s C o u rt to u c h e s on the problem of community resources in a remark about th e s e s p e c i a l s c h o o ls : So o f t e n , I am in the uncomfortable p o sitio n of deciding w h e th er to send a troubled ch ild to a c o rre c tio n a l i n s t i ­ t u t i o n o r back to her home and school. I say to m yself, • I f o n ly she could remain in the community and s t i l l r e ­ c e iv e in d iv id u a l a tte n tio n , expert s o c ia l work, p sy ch iat­ r i c tre a tm e n t and the a ssista n c e of a guidance counselor*1 The ’6 0 0 ’ school which has worked f o r boys, c e rta in ly sh o u ld be tr ie d fo r g i r l s . I t may not be the f in a l re ­ medy, b u t I t w ill be a step in the r ig h t d ire c tio n .^ I n th e c h ild * s neighborhood, the P olice Department’s A th le tic League and p a r t i c u l a r l y th e J u v e n ile Aid Bureau have been doing important re c re a tio n ­ a l work and have so u g h t to provide some guidance and supervision f o r problem y o u n g s te r s .

F u r th e r , f a i r l y rec e n tly , th e New York C ity Youth Board was es­

t a b l i s h e d t o e x te n d th e preventive program. I n a d d i t i o n , two divisions of the Domestic R elations Court were s e t up t o s e r v e c h il d r e n b e fo re th e ir problems and p a tte rn s of delinquency become d e e p ly e n g ra in e d .

One i s the Bureau of Adjustment which serves as an inform al

c o u r t a d ju n c t f o r th o s e youngsters who can b e s t be served by inform al process­ in g r a t h e r th®“ th ro u g h th e f ilin g of a reg u la r p e titio n in the C hildren’s C o u rt.

W ith more p e rs o n n e l, i t i s lik e ly th a t th is im portant work could be

e x te n d e d m a t e r i a l l y and t h a t g re a te r emphasis could be placed on a c tu a l t r e a t ­ m ent beyond th e r e f e r r a l function. C o u rt i s known a s S ch o o l P a rt.

Another sectio n of the Domestic R elations

Operating with i t s own personnel, i t aims a t

p ic k in g up th o s e y o u n g s te rs whose d i f f ic u lt i e s fin d symptomatic expression p a r t i c u l a r l y i n th e form o f truancy and who so o fte n , in the absence of tim ely

1.

Mathew J . D is e r io quoted in a se rie s on teenage delinquency by Joseph Kahn i n th e New Y ork P o s t. May U , 1950* P« 36.

183 and proper a s s i s t a n c e , 'become in v o lv e d i n o th e r , more a n t i - s o c i a l form s o f delinquencies.

A r e l a t i v e l y newer elem ent i n th e c o u rt s t r u c t u r e , th e School

P art faces th e p r e s s u r e o f a v e iy heavy caselo ad f o r th e p e rso n n e l a ssig n e d to i t . The Prelim inary H a n d lin g o f Young D elin q u en ts C h ild re n in v o lv e d i n w hat may be c o n sid e re d th e f a i r l y " ty p ic a l" delinquencies s u c h a s t h e p o p u la r o ffe n s e o f "b re a k in g and e n te r in g ," have th e ir f i r s t c o n t a c t w i t h th e m achinery o f th e law end th e c o u rt a t a l o c a l le v e l.

I f a p p re h e n d e d i n th e c o u rse o f some such a c t io n , th e y a re o r d in a r ily

taken to the p r e c i n c t p o l i c e s t a t i o n where e f f o r t i s made to re a c h a p a re n t to permit a h e a r i n g i n C h ild r e n 's C ourt on th e same day.

When t h i s cannot

be arranged, i f t h e o f f e n s e i s o f a minor n a tu r e , th e y o u n g ste r m ight be a l ­ lowed to re tu rn home i n th e custody o f a p a re n t u n t i l th e n e x t c o u rt s e s s io n . In h is in te rv ie w s w i t h y o u n g s te rs who were d e ta in e d , th e i n v e s ti g a t o r o c c a sio n a lly found s tr o n g h o s t i l i t y to th e p o lic e t h a t d id n o t appear to be b ased on a c u ltu ra l p a t t e r n o f d i s l i k e , b u t r a t h e r cm f i r s t - h a n d e x p e rie n c e s o f "rough­ ing up" by i n d i v i d u a l members o f th e p o lic e fo rc e ( a t tim es i n th e p ro c e ss of apprehension, o r i n a n e f f o r t to o b ta in a d d it i o n a l in fo rm a tio n ).

Young­

ste rs whose o f f e n s e s a r e of a more s e rio u s s o r t and th o se who a re p ick ed up a t night but w hose p a r e n t s a re r e l u c t a n t to ap p ear a t th e p r e c in d t o r p erh ap s want the c h ild r e n t o h a v e th e e x p e rie n c e o f d e te n tio n a re ta k e n d i r e c t l y to a temporaiy d e t e n t i o n c e n t e r . Detention For r e a s o n s t h a t a r e n e i t h e r e n t i r e l y a p p a re n t n o r v a l i d , th e de­ tention of y o u n g s te r s i n th e C ity o f New York i s n o t e x a c tly a m u n icip al s e r ­ vice.

While t h e c i t y f u r n is h e s m ost of th e money f o r th e c a re o f c h ild re n

184 who a r e b e in g te m p o ra rily d e ta in e d , t h i s s e rv ic e i s provided by su b sid ized p r i v a t e c h a r i t a b l e ag en cies.

At p r e s e n t, beys up to s ix te e n y e a rs o f age ( a t

th e tim e o f o ff e n s e ) from fo u r of th e boroughs o f th e C ity o f New York a re de­ t a i n e d a t Y outh House in lower M anhattan.

With some e x c e p tio n s, Bronx boys

a r e d e ta in e d a t a s h e lte r o p e ra ted by th e S o c iety f o r th e P rev en tio n o f C ru e lty to C h ild re n i n th e Bronx.

D espite th e good in te n tio n s w ith which th e l a t t e r

a gen cry was fo u n d ed , a s a d e te n tio n c e n te r i t has been under severe and w arran t­ ed c r i t i c i s m f o r many in ad e q u ac ie s.*

In th e re c e n t r e p o r t, While C hildren W ait,

p re p a re d by th e Community S erv ice S o ciety o f New York, th e re i s ra is e d th e p e r t ­ i n e n t q u e s tio n o f why a youngster who happens to be a Bronx re s id e n t should be c o n fin e d i n th e l o c a l S h e lte r f o r a month o r so , when o th e rs liv in g in d i f f e r ­ e n t s e c tio n s o f th e c ity can be s e n t to Youth House, where d e s p ite c e r ta in sh o rtc o m in g s, t h e r e a re a t l e a s t a p ro g re s siv e program , more adequate s t a f f , p la n n e d r e c r e a t i o n and c li n i c a l p e rso n n e l.

Comparison w ith d e te n tio n f a c i l i t ­

i e s o u ts id e o f New York, m oreover, make such an episode in th e l i v e s o f New York c h ild r e n a p p e a r i n an even more fa v o ra b le lig h t.* *

*

C h ild re n examined in The Bronx have from tim e to tim e given v e n t to t h e i r d i s s a t i s f a c t i o n , boredom, j u s t i f i e d h o s t i l i t y o r fe e lin g o f re s ig n a tio n a t h a v in g "nothin g to do b u t s i t around and maybe read comic books*"

#*

C o n d itio n s elsew here a re thrown i n to sharp r e l i e f by such e x c e rp ts as t h a t which fo llo w s: No a c c u r a te fig u re s a re a v a ila b le because th e re i s no law r e q u ir in g communities to r e p o r t such s t a t i s t i c s . But th e U n ited S ta te s C h ild re n 's Bureau e stim a te s t h a t between 50,000 and 100,000 ch ild ren a re d e ta in e d in common j a i l s each y e a r — which means th a t many sh a re c e l l s w ith a d u lt c rim in a ls , th ie v e s , p r o s t i t u t e s and th e in s a n e . R eports d e s c rib e many o f th e s e j a i l s a s s o r d id and b r u ta l; c h ild re n committed t o them a re t r e a te d as i f th e y were " h a b itu a l c rim in a ls ." (S o u rc e: G ertrude Sam uels, "A New Road f o r th e Ju v e n ile D elin q u en t," New York Times Magazine. A p ril 23, 1950, p . 2 2 ).

185 T his does n o t im ply t h a t e v e ry th in g a t Youth House i s i d e a l .

P e r­

haps the most conspicuous h an d icap i n t h a t s e t t i n g i s th e p h y s ic a l p l a n t .

An

e ig h t-sto ry converted b u ild in g in a h e a v ily congested o ld tenem ent a r e a , b u t fo r a screened ro o f , th e y o u n g ste rs a r e e n t i r e l y w ith o u t ou td o o r r e c r e a t i o n a l fa c ilitie s .

The h e ig h t o f th e s t r u c tu r e a lo n g w ith i t s o r i g i n a l d e sig n con­

tr ib u te s to th e n e c e s s ity o f window guards and o th e r s e c u r i t y m easures which make f o r gloom and a p r i s o n - l i k e atm o sp h ere.

N e v e rth e le s s , i t i s an i n s t i t u ­

tio n in which th e p e rso n n e l a re q u ite g e n e ra l!^ g eared t o a n o n -p u a itiv e p h i l ­ osophy, and in which th e r e i s an aw areness o f th e casew ork approach and th e p o s s ib ility of u t i l i z i n g a d e te n tio n p e rio d c o n s t r u c t iv e l y .

One o f th e f e a t u r e s

of the agency i s a s p e c ia l sch o o l (P . S . 611) o p e ra te d by th e Board o f Educa­ tio n , which i s n o ta b ly a d ap ted to th e n e ed s o f th e m a la d ju ste d s tu d e n t.

F u n ct­

ioning w ith a f a i r l y sm all s t a f f , c la s s s i z e i s s t i l l much s m a lle r th a n p r e ­ v a ils in re g u la r elem en tary sc h o o ls a llo w in g f o r i n f o r m a li t y , more in d iv i d u a l ­ ized tr a in in g , and a g r e a t e r d egree o f guidance and re m e d ia l work.

The p e r­

sonnel are s p e c ia lly s e le c te d and a p p re c ia te some 6 f th e need s o f th e p a r t i c ­ u la r population w ith which th e y have t o d e a l.

U n fo rtu n a te ly , th o u g h , th e edu­

c a tio n a l program i s lim ite d to th e sch o o l y e a r o f th e Board o f E d u c a tio n , w here­ as the d e te c tio n c e n te r r e a l l y needs such a s e r v ic e a l l y e a r lo n g . Among th e o b s ta c le s i n th e way o f maximal s e r v ic e a t Youth House, the r e la tiv e ly lim ite d g e n e ra l b u d g e t (w ith a tte n d a n t r e p e r c u s s io n s on s t a f f m orale), and th e meager p ro v is io n f o r s k i l l e d c l i n i c a l p e rs o n n e l w a rra n t men­ tio n .

Though r e l a t i v e l y w e ll su p p lie d w ith p s y c h i a t r ic s o c i a l w o rk e rs, t h e r e

i s a marked im balance in th e r a t i o o f c l i n i c a l team members and a s a r e s u l t a d iag n o stic r a t h e r th an a r e a l tre a tm e n t o r i e n t a t i o n p r e v a i l s .

B r ie f d ia g ­

n o stic c o n ta c ts ep itom ize th e work o f th e h a lf - tim e p s y c h i a t r i s t and h a lf - tim e psychologist employed, i n a s e t t i n g where so much more co u ld b e acco m p lish ed .

186 P a r a l l e l problems a re p resen t a t G i r l 's Camp, the d e te n tio n c e n t e r o p e ra te d u n d e r Youth House supervision on W elfare Isla n d , New York.

T h e re ,

d e s p ite some s p e c ia l handicaps, the p h y sical p la n t, which has been a d a p te d t o se rv e a s a sm all in s t it u t io n on the c o ttag e p la n , i s a t l e a s t conducive t o a more e h e e r f d l atmosphere.

Of course, not a l l youngsters have c o n ta c t w ith

th e s e tem porary detention cen ters as ch ild ren may be re le a se d cm " p a r e n ta l bond" (rh ich does not n e c e ssa rily involve a fe e ) and because in many i n s t a n c e s th e i n i t i a l h e arin g can be held w ithout d elay .

N evertheless, in th e f i v e y e a r s

o f o p e ra tio n o f Youth House, a g re a te r p ro p o rtio n o f c h ild ren were b ro u g h t i n by th e p o lic e f o r d eten tio n while th e co u rt was n o t in session than w ere r e ­ manded d i r e c t l y by the c o u rt.

For th e p re s e n t, though, a siz ea b le segm ent

o f a l l a lle g e d d elinquents a re obliged to experience some d eten tio n i f o n ly t o b e s e n t home d ir e c tly from the i n i t i a l h e a rin g .1 C o u rt O rg a n iz a tio n The hearing of delinquency cases tak e s place in th e C h ild re n 's C o u rt D iv isio n o f th e Domestic R elations Court.

Located in f iv e boroughs o f t h e

c i t y , te n p a r t s of the Court a re devoted to cases concerning fam ily p ro b lem s ( g e n e ra lly n o n -su p p o rt), and seven to m atters c en terin g on c h ild re n .

U n til

1942 th e C h ild r e n 's Court had been p a r t o f th e Court o f S pecial S e s s io n s , b u t t h e r e a f t e r i t became an independent tr ib u n a l w ith ju r is d ic tio n over d e lin q u e n ­ c y , n e g l e c t , m a te ria l w itness and mental d e fic ie n cy a c tio n s .

In 1933> th o u g h ,

new l e g i s l a t i o n made th e C h ild re n 's Court a d iv is io n o f th e Domestic R e la ti o n s C ourt o f th e C ity of New York.

In delinquency a c tio n s , ju r is d ic tio n i s e x ­

c lu s iv e up to f i f te e n y ears of age b u t te c h n ic a lly i s to be regarded a s s h a r e d f o r i n f r a c t i o n s committed by c h ild re n not y e t six te e n a t the time o f v i o l a t i o n . .

1.

Youth House, F ifth Annual Report.

New York, 1949, p . 37.

187 O ffenses, which i f com m itted by a d u lts would c a l l f o r punishm ent by l i f e imprisonment o r d e a th , in v o lv in g y o u n g s te rs i n th e f i f t e e n t o s ix te e n y e a r category a r e excluded b e in g h andled by o th e r c o u rts u n le s s s p e c ia l p ro ce d u re 1

tr a n s f e r r in g th e s e c a se s to C h ild r e n 's C ourt i s fo llo w e d . A djudication At th e i n i t i a l h e a rin g , th e com p lain t o f th e p e t i t i o n e r i s p r e s e n t­ ed to th e judge in chambers from which th e p u b lic i s ex clu d ed .

The p eo p le

o rd in a rily p re s e n t a t t h i s h e a rin g in c lu d e th e p e t i t i o n e r o r c o m p lain a n t, th e c h ild , a p a re n t o r g u a rd ia n , p erh a p s an agency r e p r e s e n t a t i v e , a s u p e rv is in g p robation worker o r o th e r r e p r e s e n ta tiv e o f th e p ro b a tio n s t a f f , and some courtroom p e rs o n n e l.

The com p lain t a g a in s t th e c h ild i s s t a t e d and weighed

a g ain st th e s ta te m e n ts o f th e c h i l d , p a re n t, and any w itn e s s e s in v o lv e d .

If

d e sire d , an a tto r n e y f o r th e c h ild may be b ro u g h t t o c o u rt to r e p r e s e n t him , but t h i s i s n e i t h e r n e c e s s a ry n o r th e g e n e ra l p r a c t i c e .

A t t h i s h e a r in g , i f

the evidence i s e n t i r e l y to o s c a n ty t o su g g e st t h a t th e c o u rt i n te r v e n e , th e ch ild may be d isc h a rg e d and th e a c t io n a g a in s t him d ro p p ed .

In such c a s e s , i t

i s assumed t h a t th e c o u rt can se rv e b e s t by n o t i n t e r f e r i n g w ith th e norm al l i f e of th e c h ild and th e fa m ily . I f th e ju d g e d e c id e s t h a t th e c h ild seems t o have been r e s p o n s ib le fo r the a c ts he i s a lle g e d to have com m itted, a f in d in g o f d e lin q u e n c y m ight be made.

In some c a s e s , th e a lle g e d d e lin q u e n t b e h a v io r may be r e l a t e d more

d ire c tly to p a r e n ta l n e g le c t o r la c k o f s u p e rv is io n , and a f in d in g o f n e g le c t may be made in s te a d .

U s u a lly , once a f in d in g o f d elin q u en cy o r n e g le c t i s

made, (o r a t tim e s even b e fo r e ) t h e p ro b a tio n dep artm en t i s c a lle d upon to

1.

By amendment o f S e c tio n 2 , P arag rap h 15 o f th e Domestic R e la tio n s C o u rt A c t.

188

f u r n i s h th e judge with an In v e stig a tio n of the c h ild covering such d e t a i l s a s th e n a tu re o f h is home re la tio n s h ip s , neighborhood co n d itio n s) h i s s c h o o l r e c o r d and any d ata on h is mental and p h y sical s ta tu s a v a ila b le from l o c a l a g e n c ie s . a d jo u rn e d .

Pending conduct of th is In v e stig a tio n ) th e hearing i s o r d i n a r i l y Children whose offenses do n o t appear to be n otably s e r i o u s and

whose homes seem reasonably adequate a re u su a lly paroled* u n t i l th e a d jo u r n ­ ed d a t e .

"Repeaters" are u su a lly remanded to Youth House o r Bronx S h e l t e r ,

and g i r l s a re sen t to G ir l's Camp.

The d ecisio n to request a c l i n i c a l e v a l ­

u a ti o n o f th e c h ild (performed e ith e r a t th e Court C linic or a t Youth House o r G i r l 's Camp) i s o rd in a rily an outgrowth of observation of th e c h i l d d u r­ in g t h i s i n i t i a l h earing.

The p a te n tly d e fe ctiv e o r psychotic y o u n g s te r may

b e s p o tte d and re fe rre d f o r study.

Those children whose emotional p ro b lem s

a r e l e s s o v e rt but who need c lin ic a l se rv ice s may n o t be detected u n d e r th e p r e s e n t arrangem ent) however.

Thus, as an outgrowth of the i n i t i a l h e a r i n g ,

th e c h i l d i s assigned to a probation o f f ic e r who w ill undertake a f i e l d s tu d y , and th e re q u e s t fo r c li n i c a l evaluation i s o rd in a rily made. About the a c tu a l conduct of c o u rt h earin g s, the in v e s tig a to r c an say r e l a t i v e l y l i t t l e because personal observations in the courtroom w ere i n ­ fre q u e n t.

Considerable second-hand inform ation was acquired, th o u g h , a b o u t

h a p p en in g s a t hearings as w ell as about th e backgrounds and p e r s o n a l i t i e s o f th e l a r g e number of differently equipped judges who serve the C h ild r e n 's an d Fam ily C o u rts.

Some a re a source of much concern to c lin ic a l p e rs o n n e l b y

v i r t u e o f t h e i r convictions, a tt i tu d e s , and p e rs o n a litie s .

Others h av e a

s e a l f o r t h e i r work, tra in in g , competence and s e n s itiv ity equipping them u n -

*

The te rm "parole" i s used b u t not in i t s customary sense — r a t h e r t o mean re le a se pending fu rth e r h earin g .

189 u s u a lly w e ll f o r t h e i r r e s p o n s i b i l i t i e s .

A gain, th e human elem ent i s o f

g r e a t im p o rta n c e , and a fra n k and p o in te d o b s e rv a tio n by Judge P o l i e r on j u d i c i a l p e rs o n n e l in g e n e ra l may be c it e d a s n o t e x c e p tin g members o f th e bench i n New York: 1 suppose h u m ility i s n o t th e c h a r a c t e r i s t i c m ost l i k e l y t o come t o mind in d e s c rib in g members o f th e j u d i c i a r y . Too o f t e n , in s t e a d , we f in d a rro g a n c e and s e l f - r i g h t e o u s ­ n e s s , th e need f o r p rea ch in g a t peo p le r a t h e r th a n h e lp in g them , th e Olympic w rath a g a in s t th e wrongdoer r a t h e r th an human u n d e rs ta n d in g , and im p atien ce w ith th e tr o u b le s o f th e many anonymous ’l i t t l e * p e o p le who come b e fo re th e C ourt r a t h e r th a n an a p p re c ia tio n o f th e f u l l p o s s i b i l i ­ t i e s o f p a t i e n t l i s t e n i n g and e a r n e s t in q u ir y a s t o how t h e i r tr o u b le s o r problem s may be s o lv e d .1 The Study o f th e C hild* At p r e s e n t , th e assignm ent o f y o u n g ste rs to p ro b a tio n o f f i c e r s , which fo llo w s th e i n i t i a l h e a rin g in th e C h ild r e n 's C o u rt, i s o r d in a r ily made on th e b a s i s o f r e l i g i o n .

The y o u n g ste r i s a l l o t t e d to a p ro b a tio n

w orker p r e f e r a b l y f o r th e f i e l d stu d y and p a r t i c u l a r l y f o r s u p e rv is io n to someone o f h i s own f a i t h .

T his p r a c t ic e h as le d t o p la c in g a g r e a t d e a l o f

w eight i n th e employment o f p ro b a tio n p e rs o n n e l on th e r e l i g i o n o f th e p ro s ­ p e c tiv e w orker p erh a p s a t tim e s more th an on o th e r , p r o f e s s io n a l a t t r i b u t e s . S e v e ra l o th e r d i f f i c u l t i e s i n p ro v id in g c h ild r e n b e fo re th e c o u r t w ith q u a l­ i t a t i v e l y m ost s a t i s f a c t o r y p ro b a tio n s e r v ic e s e x i s t — n o t th e l e a s t o f which i s s a l a r y l e v e l .

In r e c e n t sta te m e n ts th e P re s id in g J u s t i c e , Hon. John

Warren H i l l , p o in te d t o th e in a d e q u ate s a l a r i e s p a id t o p ro b a tio n p e rs o n n e l

1.

J u s t i n e Wise P o l i e r quoted by Edwin J . Lukas, "More on th e C h ild r e n 's C o u rt and Cognate H a t te r s ," The Record o f th e A s s o c ia tio n o f th e B a r o f th e C ity o f New York, V ol. 3* No. 8 , Nov. 1948, p . 340.

*

Mr. C la re n c e L eeds, P ro b a tio n S u p e rv iso r o f M anhattan Fam ily C o u rt, was g e n e ro u s in a s s i s t i n g th e i n v e s t i g a t o r to g e t a more p r e c is e p i c t u r e o f e o u r t f u n c tio n in g w ith s p e c ia l r e f e re n c e to p ro b a tio n s e r v ic e s ahd p ro b le m s.

190 a s a d e t e r r e n t to the recruitm ent of w e ll-tra in e d p eople.1 T urnover i s f a i r i

l y h ig h among the one hundred and f i f t y probation workers whose s a l a r i e s ra n g e from $2,710 to $3»720 annually.

As Ju s tic e Panken remarked, "Our good

men le a v e us although they lik e the work. n e e d o f good probation o f f ic e rs .

And th is co u rt stands t h e m o st i n

How they lea rn a t the expense o f th e c h i l d ­

re n ." 2 Besides formal or academic q u a lific a tio n s , though, th e p e r s o n a l i t y o f t h e w orker in the s e le c tio n o f a probation s t a f f can hardly be overem pha­ s iz e d .

A statem ent by Schmideberg in another context ap p lies as w e l l t o th e

p r o b a tio n counselor:

"To make genuine contact with h is charge, t h e p a r o l e

o f f i c e r m ust f i r s t become human and r e a l .

He must be capable o f i d e n t i f y i n g 3 h im s e lf w ith the p arolee and speaking to him on h is own em otional l e v e l . " I n a d d i t i o n , he needs lengthy tra in in g , sp ecialized s k i l l s and a s i n c e r e i n t e r ­ e s t i n h i s work. Other d i f f i c u l t i e s impeding th e provision of h ig h e st l e v e l p ro b a ­ t i o n s e r v ic e s grow out of the f a c t th a t f o r some time p o sitio n s have b e e n f i l l ­ e d by tem porary employees q u ite a few of whom f a l l to meet c u r r e n tly a c c e p te d p r o f e s s i o n a l standards.

This i s now being remedied to some e x te n t by t h e r e ­

p la c e m e n t ofmtemporary workers w ith C iv il Service examinees, y e t i n p a r t f o r r e a s o n s o f th e salary le v e l and re lig io u s r e s tr ic tio n s on e l i g i b l e s , n o t a l l v a c a n c ie s a re f i l l e d .

Another com plication a ris e s from the f a c t t h a t w h ile

1.

Jo h n W. H ill, "The C hildren’s Court - New York C ity ," A Colloquium on Ju v e n ile Delinquency, p . 61.

2.

Ja c o b Panken), in an interview with Margaret E l l i o t t , s t a f f w r i t e r o f th e New York World Telegram and Sun. A pril 2A, 1950, p,.' 8 .



M e l it t a Schmidberg, "The Parolee R eports," Focus. January 1950, p . 3 ( o f r e p r in t) .

191 th e p ro b a tio n s t a f f may n o t b e o v e rlo a d e d i n th e l i g h t o f t h e i r p r e s e n t com petence, from th e p o in t o f view o f d o in g a n o p tim a l jo b i n r e h a b i l i t a t i o n , t h e i r c a se lo a d i s h ig h e r th a n w hat n i g h t b e d e s i r a b l e .

I n c id e n ta lly , s h o r t­

ages i n c l e r i c a l p e rs o n n e l and o f f i c e sp a c e f u r t h e r i n t e r f e r e w ith t h e i r fu n c tio n in g . As p a r t o f th e p r o b a tio n r e p o r t on th e c h i l d , th e r e i s in c o rp o r­ a te d th e s ta te m e n t o f th e c o m p la in a n t, and a good d e a l o f background inform a­ tio n .

The p ro b a tio n o f f i c e r , i n th e c o u rs e o f h i s I n v e s tig a tio n w i l l g a th e r

in fo rm a tio n on th e fa m ily , th e heme and n eig h b o rh o o d c o n d itio n s , r e l i g i o u s a f f i l i a t i o n s , and w i l l c o n ta c t th e s c h o o l f o r a d v ic e on th e child* s m en tal and p h y s ic a l c o n d itio n and p r o g r e s s r e c o r d .

S o c ia l S e rv ic e Exchange d a ta

and in fo rm a tio n on p r i o r c o u r t a p p e a ra n c e s a r e in c o rp o ra te d along w ith s p e c ia l r e p o r t s from any a g e n c ie s t h a t may have se rv ed th e fam ily o r th e c h ild p r e v io u s ly .

B efo re m aking recom m endations, th e p ro b a tio n w orker i n t e r ­

view s b o th th e c h i l d , th e p a r e n t s an d a t tim e s th e c o -d e lin q u e n ts in v o lv ed in th e p e t i t i o n . I f a c l i n i c a l s tu d y h a s b e e n re q u e s te d a t th e child* s h e a rin g , th e p ro b a tio n w orker makes an a p p o in tm e n t f o r th e c h i l d .

I f n o t , and i f

in v e s tig a tio n o f th e y o u n g s t e r 's b a ck g ro u n d and o b s e rv a tio n s in th e course o f assem b lin g th e p ro b a tio n d a t a u n d e rs c o r e th e d e s i r a b i l i t y o f such a s t e p , th e p ro b a tio n o f f i c e r may u n d e rta k e t o a sk th e judge to a u th o r is e such a stu d y .

I n any e v e n t, t h e p r e s e n t system p ro v id e s no pro ced u re

whereby a l l y o u n g s te rs who a r e a d ju d i c a t e d ( t o sa y n o th in g o f a l l young­ s t e r s a p p earin g b e f o r e th e c o u r t) may b e o b se rv ed and may have t h e i r re c o rd s s tu d ie d by s p e c i a ll y t r a i n e d p e rs o n n e l w ith c l i n i c a l backgrounds f o r s ig n s o f p a th o lo g y s u f f i c i e n t t o w a r r a n t more in te n s iv e o b s e rv a tio n . M oreover, no c l i n i c a l s t a f f member s i t s i n on i n i t i a l h e a rin g s t o se rv e

192 a s c o n s u lta n t to th e judge or th e probation s t a f f so t h a t y o u n g s te r s who r e q u i r e c lin ic a l a id w ithout being e ith e r obviously p sy c h o tic o r d e f e c t i v e can b e id e n tifie d in order to receiv e it*

C lia iq ftl SflTYiwa Once a c li n i c a l study i s authorized and an appointm ent I s r e q u e s te d , i t usually tak es some fo u r weeks before th e c h ild c an b e se e n a t t h e P sy ch ia tric C linic*

The tin e la g between req u est and a p p o in tm e n t

may b e sh o rte r during some p e rio d s, b u t- a cu rre n t newspaper a c c o u n t c i t e s an even longer delay.

Where a c h i l d 's courtroom behavior i s so s e r i o u s l y

d e v ia n t, though, i t i s u su ally p o ss ib le f o r the judge to make a rra n g e m e n ts f o r a p sy c h ia tric study sooner.

This a p p lie s, however, to c a s e s c o n s id e r e d

em ergencies. The la g between the req u e st fo r appointments and I n i t i a l v i s i t s a n d th e lim ita tio n in th e q u a lity of serv ices rendered can b e r e l a t e d r a t h e r d i r e c t l y to the sm all s t a f f of p ro fe ssio n a l workers on whose s h o u ld e r s l i e s t h e burden of an extremely heavy caseload.

While of c o u rse , t h e C h i l d r e n 's

C o u rt c lin ic i s not th e only resource in th e Mew Tork a re a , s t i l l t h e P sy ­ c h i a t r i c C linic rep re se n ts the prim ary diag n o stic and tre a tm e n t a g e n c y f o r d e lin q u e n t and neglected youngsters l a a c ity o f e ig h t m illio n p e o p l e .

If

i t i s f e l t th a t "a working team o f one c lin ic a l p sy c h o lo g is t, tw o o r t h r e e p s y c h ia tr ic s o c ia l workers, one p s y c h ia tr is t and one o r two c l e r i c a l w o rk e rs c an a c c ep t something over 300 new cases a yeai;"^ a s t a f f o f e i g h t h a l f - t i m e p s y c h i a t r i s t s , fiv e h alf-tim e p sy ch o lo g ists, and fo u r f u l l - t i m e p s y c h i a t r i c s o c i a l workers, plus student tr a in e e s ,

can hardly be expeoted t o do j u s t i c e

1.

George S. Steve&saa, and Geddes Smith, £6414 Guidance C llr ii« « r p . 5 5.

■*.

in clu d in g two p s y o h ia tr ls ts , two p sy c h ia tric s o c ia l w o rk ers and tw o stenographers on a temporary g ran t from th e Mew Tork Y o u th B o a rd .

193 to so huge a p o p u la tio n .

Y e t, t h i s a w a ll group o f w o rk ers i s u n d e r c o n sta n t

p re s s u re t o serv e th e l a r g e s t number o f e a s e s .

The PiftgaoaU o SmeyIqs I n th e co u rse o f th e d a i l y c l i n i c a l program , th e p s y c h i a t r i s t a s­ sig n ed t o th e d ia g n o s tic s e r v i c e i s c a l l e d upon t o re a d th ro u g h th e m a te ria l fu rn is h e d by th e p r o b a tio n o f f i c e r , t o p erfo rm a p h y s ic a l e x a m in a tio n , to stu d y th e c h ild a lo n g w ith a p a r e n t o r g u a rd ia n . scheduled f o r a f o u r h o u r w orking d a y .

Two such c a s e s a r e u s u a lly

S im ila r ly , th e p s y c h o lo g is ts , who

in th e p a s t few y e a r s have made c o n s id e r a b le p ro g re s s i n r a i s i n g th e stan d ­ a rd s o f th e s e r v ic e s p e rfo rm ed , a r e u n d e r s i m il a r p r e s s u r e t o se e two cases in th e same p e rio d o f tim e .

E a r l i e r , when th e p s y c h o lo g ic a l s e r v ic e s were

lim ite d t o th e e s ta b lis h m e n t o f an i n t e l l i g e n c e q u o tie n t and t o a q u ick check on sc h o o l achievem ent, a heavy c a s e lo a d was f e a s i b l e .

W ith t h e g r e a te r em­

p h a s is on p r o je c tiv e te c h n iq u e s t o a f f o r d a more dynamic view o f th e C hild and w ith an improvement i n th e q u a l i t y o f th e p s y c h o lo g ic a l r e p o r t s , co n tin ­ ued p r e s s u r e f o r th e p ro d u c tio n o f such a volume o f c a s e s h a s p rev e n ted th e perform ance o f q u a l i t a t i v e l y maximal s e r v i c e s . On o c c a sio n , th e number o f c a s e s a w a itin g a t t e n t i o n n e c e s s i t a t e s th e d e la y o f th e h e a rin g on t h e a d jo u rn e d d a te because i t i s n o t always p o s s ib le t o se e th e c h ild and p a r e n t w ith in th e tim e a l l o t t e d , causing th e e x te n sio n o f remands and th e re s c h e d u lin g o f c l i n i c a l a p p o in tm e n ts b o th f o r c h ild re n and w orking p a r e n t s .

A f u r t h e r b o ttle n e c k a r i s e s a t a c l e r i c a l

l e v e l: even i f a l l c a se s w ere s t u d i e d ,

subm ission o f a d ia g n o s tic r e p o r t

to th e c o u rt nay a w ait t r a n s c r i p t i o n o r ty p in g by a h e a v ily ta x e d c l e r i c a l s ta ff.

(G e n e ra lly , th e r e i s much c o n s c io u s n e s s o f due d a t e s , and th e c o u rt

has shown some f l e x i b i l i t y i n w orking w ith telep h o n e d sum m aries a t tim e s ) . But even from th e p o in t o f view o f d o in g m erely an a d e q u a te j o b , a much

la r g e r s t a f f i s needed. i s an accom odation to th e p a tie n ts , every e f f o r t i s made f o r t h e com pletion o f the c l i n i c a l study in one v i s i t so t h a t c h i l d r e n n e e d n o t lo s e too much time from school n o r p a re n ts too much in l o s t w a g e s .

As a

r e s u l t , in one morning, th e p sy ch o lo g ist and p s y c h i a t r i s t m ust c o m p le te t h e i r work w ith th e p a tie n t.

Both are handicapped by t h e l a c k o f a p r e v io u s

in te rv ie w and e v alu atio n o f th e p a tie n t by a p s y c h ia tr ic s o c i a l w o rk e r who, among o th er th in g s , can more adequately prepare th e p a t i e n t f o r t h e s u r ­ p r i s e , f o r in s ta n c e , o f being asked to s i t down and draw some human f i g u r e s , o r t o work block-design problem s, o r, fo r th a t m a tte r t o u n d r e s s f o r a p h y sic a l exam ination.

Very o fte n , th e purpose o f th e c l i n i c a l v i s i t i s e x ­

trem ely haay to th e p a tie n t, and i f he does n o t reg a rd t h e c l i n i c i a n a s a # re p re s e n ta tiv e o f law enforcem ent, he i s often on th e d e f e n s i v e w i t h t h e rem ark, "I'm not c ra zy ".

Without adequate p re p a ra tio n f o r t h e c o n t a c t , t h e

c l i n i c a l w orkers, b e sid es having a h ard er job o f e s t a b l i s h i n g r a p p o r t w ith the p a tie n t nay be handicapped f u r th e r by th e la c k o f e s s e n t i a l b a c k g ro u n d inform ation which m ight be affo rd ed by a. p s y c h ia tric s o c i a l w o rk e r t o p r o ­ vid e p ersp ectiv e a g a in s t which to ap p raise c li n i c a l o b s e r v a t i o n s .

And n o t

only a re th ese la c k in g , b u t a t tim es to o , probation s t u d i e s a r e h e l d u p a t th e stenographic p o o l, otherw ise delayed, o r simply a r e l a c k i n g i n n e c e s ­ sary d e t a i l s .

*

The aura of th e s e ttin g i s so p e r s is te n t, (e s p e c ia lly w ith t h e c l i n i c housed in o r n e x t to th e co u rt b uilding) t h a t i t f r e q u e n t l y t a k e s q u ite a while f o r th e c h ild to g e t away from th e common p s y c h o l o g i s t o r s o c ia l workerlpolicemen confusion: ("You mean y o u 'r e n o t a c o p ? ") A fter a l l , i t tak e s d e f in ite f a i t h f o r th e d e lin q u e n t c h i l d t o f e e l f r e e to ta lk about h im self, th e th in g s he has done an d w h a t h e m ig h t l i k e to do w ith th e assurance th a t th ese c o n fid e n c e s c a n b e d i s c l o s e d w ithout t h e i r being used a g a in st him in th e courtroom on a n o t h e r f l o o r . (Extensive n o te -ta k in g during c li n i c a l c o n ta c ts o n ly a d d s t o t h e s e aroused su sp icio n s and in c re a se s r e s is ta n c e ) .

195 Under a o n e - v i s i t arrangem ent, th e p a tie n t i s sh ared by th e psy­ c h i a t r i s t and p s y c h o lo g is t.

One does n o t have th e advantage o f f u l l know­

le d g e o f th e f in d in g s o f t h e o th e r .

L i t t l e tim e i s a v a ila b le f o r a case

c o n feren ce — r a t h e r , im p re s s io n s a re exchanged and d a ta may be d isc u sse d in fo rm a lly , pending th e p r e p a r a tio n o f a r e p o r t.

D ia g n o stic r e p o r ts a re

p rep a red w ith o u t th e c o ll a b o r a t io n o f a p s y c h ia tr ic s o c ia l w orker, a s o c i o l o g i s t , o r o th e r s p e c i a l i s t s , by th e p s y c h i a t r is t o r d in a r ily a f t e r th e p s y c h o lo g ic a l r e p o r t i s ty p e d .

In t h i s way th e p re s s u re o f th e case­

lo a d r e s t r i c t s th e q u a l i t y o f th e s e rv ic e ren d e red . Of c o u rs e , some p a t i e n t s who r e p re s e n t more enigm atic d ia g n o s tic problem s may b e re s c h e d u le d f o r f u r th e r stu d y . b u t r a t h e r w ith s p e c i a l c a s e s .

T his i s n o t done r o u tin e ly

There i s some seaso n al v a r ia tio n i n work­

lo a d and p a t i e n t s do n o t a lw ay s show up, b u t a schedule o f about e ig h t o r n in e p a t i e n t s c o n fro n ts e a c h p sy c h o lo g is t and p s y c h i a t r is t f o r h i s twenty hour week. P a t i e n t s seen on a c o n s u lta tio n b a s is can o fte n produce a good d e a l o f m a te r ia l i n an u n in te r r u p te d hour c o n ta c t.

Under p re s e n t o p e ra tin g

c o n d itio n s , though* th e p s y c h i a t r i s t must re a d through th e Inform atio n f u r ­ n ish e d by th e p ro b a tio n d e p a rtm e n t, must do a p h y sic a l exam ination in c lu d ­ in g a q u ic k n e u r o lo g ic a l ch eck (v ag in a l o r s e r o lo g ic a l s tu d ie s a ls o have * been done from tim e t o t i m e ) , must in te rv ie w th e c h ild and see a p a re n t o r g u a rd ia n .

T h e r e a f te r , h e m ust ev alu ate p sy c h o lo g ic al fin d in g s and p e r­

hap s c o n fe r b r i e f l y w ith t h e p s y c h o lo g is t, d i c t a t e a r e p o r t to th e c o u rt

*

Time and money m ight be saved and b e t t e r ra p p o rt e s ta b lis h e d w ith th e p a t i e n t i f p h y s ic a l exam inations o f a l l p a tie n ts were done by s p e c ia l m ed ical e x am in e rs. By adding a p e d ia tr ic ia n o r a n o th e r p h y sic ia n to th e P h y s io lo g ic a l L a b o ra to ry , th e p s y c h ia tr ic s t a f f could fu n c tio n a s s p e c i a l i s t s d e v o tin g more tim e and a tt e n t i o n t o th e complex p e rso n a l­ i t y problem s t h a t e a c h p a ti e n t p r e s e n ts .

196 and re v is e i t b efo re subm ission.

Every etep in th e p r o c e s s I s tim e-co n su m ­

in g , and he freq u en tly has to contend w ith th e r e s i s t a n c e a n d s u s p ic io u s n e s s o f a p a tie n t who coves to th e c lin ic n o t because he f e e l s t h e n e e d h i m s e l f , b u t ra th e r because he has been ordered to do

bo

by t h e c o u r t*

T h ese f a c t o r s

fu rth e r o i ti g a te a g a in st o b taining a r e a lly r ic h d i a g n o s t i c p i c t u r e * The psychologist contends w ith a s im ila r r e s e r v e on t h e p a r t o f th e p a tie n t who i s freq u e n tly even nore th reaten ed by t h e m anner i n w h ich h i s in te l le c t u a l and en o tio n al inadequacies have to be e x p o sed a n d h i s d e fe n s e s p e n etrated .

P a rtic u la rly s k i l l f u l handling i s n e c e s s a r y f o r some p a t i e n t s

who beoove q u ite anxious and defensive when c o n fro n te d by m a t e r i a l s o f th e p ro je c tiv e methods f o r p e rs o n a lity study which a re p l a y i n g a m ore p ro m in e n t *

p a r t in th e work of th e p sy c h o lo g ist.

Under th e im p a c t o f a new s t a f f ,

though, th e psychological se rv ice has been extended q u a n t i t a t i v e l y an d q u a lita tiv e ly *

l e t even today, such to o ls as th e R o rsc h a c h a n d t h e Them atic

Apperception T ests because o f t h e i r r e la tiv e ly tim e-co n su m in g n a t u r e a r e n o t used f o r most p a tie n ts .

Given s u f f ic ie n t tim e , t h e p r o v i s i o n a l p s y ­

ch o lo g ists now serving th e c lin ic in Manhattan (a s w e l l a s The B ro n x an d Queens) could a ffo rd a much ric h e r and more m eaningful d i a g n o s t i c v iew o f th e p a tie n t using newer p ro je c tiv e methods in c lu d in g t h e p l a y t e c h n iq u e s . Mot only the p ressu re o f caseload on th e n u m e r ic a lly s m a ll s t a f f , b u t the very d iv isio n of th e p sy c h ia tric c li n i c i n to a d i a g n o s t i c an d a treatm ent se rv ice i t s e l f coupled w ith th e p re s e n t em p h a sis on t h e fo rm e r makes f o r f u r th e r lim ita tio n on the se rv ic e s re n d e re d .

W hile aw are o f th e

evexydey, r e a l i s t i c needs o f th e ch ild ren as w ell a s o f t h e c o u r t , a sub­

*

At f i r s t , the in v e s tig a to r found th e c li n i c p o o rly s u p p l i e d w ith t h e b a sic to o ls fo r p e rs o n a lity ev alu atio n .

197 s t a n t i a l segment o f th e c l i n i c a l team c h a fe s a t th e s t r e s s on th e d ia g n o s tic f u n c tio n , p a r t i c u l a r l y know ing how d i f f i c u l t i t i s f o r a c h ild to o b ta in low c o s t o r f r e e p s y c h i a t r i c tr e a tm e n t i n th e New York a r e a .

Planning by

c l i n i c a l members i s g r a r e l y r e s t r i c t e d by th e la c k o f re s o u rc e s p ro v id in g p sy c h o th e ra p e u tic s e r v ic e s c o u p led w ith th e p a u c ity o f p ro sp e c ts f o r staking n e ce ssa ry e n v iro n m en tal c h a n g e s.

As f o r p sy c h o th e ra p y , th e c lin ic ia n knows

very w ell t h a t e x c e p t f o r t h e few c a se s who m ight b e a b le to pay a p r iv a te p r a c t i t i o n e r , a n y th in g re s e m b lin g in te n s iv e p sy c h o th era p y i s very hard to a rra n g e .

The Je w ish B oard o f G u ard ian s, d e s p ite i t s lo n g w aitin g l i s t re ­

mains one o f th e s u r e s t s o u rc e s f o r o b ta in in g needed psychotherapy ( f o r c h ild re n o f t h a t den o m in atio n ) among th e v a r i e ty o f a g e n c ie s o th e r than th e T reatm ent S e rv ic e o f th e c o u r t .

A sen se o f f u t i l i t y i s engendered among

th e c l i n i c a l team a s a r e s u l t o f recommending o u t - p a t i e n t trea tm e n t f o r y o u n g ste rs a lth o u g h th e community i s s h o r t o f th e r e s o u rc e s to make th e in d ic a te d h e lp a r e a l i t y . I n th e p r o c e s s , t h e c o u r t 's own T reatm ent S e rv ic e i s c a lle d upon to assume th e r e s p o n s i b i l i t y f o r a la r g e segment o f th e p a tie n ts f o r whom o u t- p a tie n t p sy ch o th erap y i s c o n sid e re d d e s i r a b l e .

T reatm ent by o th e r

a g en c ie s b e in g o f te n im peded by d en o m in atio n al re q u ire m e n ts , o r vexy long w a itin g l i s t s o r f e e s f o r s e r v i c e s e n t i r e l y beyond th e means o f th e average c o u rt c a s e , th e tre a tm e n t arm o f th e c l i n i c comes u n d e r a good d e al o f p re s­ su re .

F or y o u n g ste rs whose em o tio n al problem s a r e more severe than a

n e u r o s is , i f th e y o u n g s te r i s c l e a r l y p s y c h o tie , o r d i n a r i l y a s t a t e h o s p ita l commitment can b e a rr a n g e d .

B u t b o r d e r lin e c a s e s o f t e n cannot q u a lif y f o r

adm ission t o th e few s t a t e h o s p i t a l s c h il d r e n 's w a rd s, and i n th e community cannot re c e iv e in te n s i v e enough h e lp . t i g h t su p p ly .

M ental h e a lth so u rc e s a re in extrem ely

198 As p a r t o f th e r e h a b ilita tio n process* c h a n g in g t h e p a t h o l o g i c a l environment surrounding th e c h ild may be n ecessary *

T h is n a y e n t a i l p la c e ­

ment in a s u ita b le f o s t e r home o r i n an i n s t i t u t i o n w ith a p r o g r e s s i v e p ro ­ gram and perhaps concurrent psychotherapeutic s e r v ic e s * i s tr a g ic a lly f a r from what would be d esirab le*

The a c t u a l s i t u a t i o n

I n r e g a r d t o f o s t e r home

placement* J u s tic e H ill has cautioned: Xfce s itu a tio n w ith re s p e c t to p la c in g n e g l e c t e d c h i l d r e n who a re in need o f removal from t h e i r homes a n d i n d an ­ g er o f becoming se rio u sly d e lin q u e n t i s v e r y g ra v e * L a s t y e a r we had 1681 a lle g e d ly n e g le c te d c h i l d r e n b e f o r e th e court* o f whom we were ab le to f i n d lo n g - tim e c a r e f o r only 439* There a re j u s t n o t enough i n s t i t u t i o n s o r b o ard ­ in g homes to meet our n e e d s.•• We have in New Tork C ity*.* a s o - c a l l e d te m p o r a ry s h e l t e r f o r n e g le cted c h ild re n , C h ild re n 's C e n t e r , w h ere u n d e r o r­ d in ary circum stances a c h ild would go a n d re m a in f o r one o r two weeks, more o r le s s a q u a ra n tin e p e r i o d , a n d th e n move to th e place o f commitment. T h is s h e l t e r h a s a cap­ a c ity of 350 children* Today in t h a t i n s t i t u t i o n 275 o f t h a t pop u latio n have been th e re f o r s i x m o n th s a n d lo n g e r because o f th e absence o f u l t i m a t e p la c e m e n t f a c i l i t i e s * •• P a rt o f th e s n a r l may be a ttr ib u te d t o l a c k o f a n o r g a n i z e d p la n f o r th e care o f c h ild re n o p e ra tin g n o t m erely l o c a l l y , b u t on a s t a t e le v e l as w e ll.

For in s ta n c e , Cooper has shown how New T o rk C i ty p r o v i d e s no d i r ­

e c t c a re , b u t New Tork S ta te assumes th e r e s p o n s i b i l i t y f o r c a r e o f d e lin ­ quents over the age of tw elve.

In th e process* t h e d e l i n q u e n t c h i l d under

twelve i s n o t provided f o r by any p u b lic agency.

2

f u r th e r d i f f i c u l t y stems from th e manner i n w h ic h t h e o p e r a tio n of c h ild -c a rin g i n s t i t u t i o n s i s e n tru ste d to p r i v a t e c h a r i t a b l e an d r e lig io u s

1.

John W. H ill* "The C h ild re n 's Court - New T ork C i t y , " A C o llo q u iu m

an faYfflUe Sflllaquenqy, pp* ti- 2 . 2.

Robert L. Cooper, "Ju v en ile Delinquency - An I n d i c t m e n t A g a i n s t Whom?"

A colloquium

an JurenU e Pallaqugngy.* p. 7 8.

199 o rg an iz atio n s*

The s i t u a t i o n h as been summarized h7 J u s tic e Dudley F. S ic h e r,

in th e s ta te m e n t:

"The C h ild r e n 's Court d i v is io n i s dependent on p r iv a te de­

n o m in ational a g e n c ie s f o r placem ent o f d e lin q u e n t boys and g i r l s and i t i s w holly dependent on such a g e n c ie s f o r placem ent o f n e g le c te d c h ild re n ; and th o se a g e n c ie s, n e c e s s a r il y s e l e c ti v e i n i n ta k e , cannot be req u ire d to acc ep t any p a r t i c u l a r c h i l d . T h o u g h government s u b s id iz e d , since th e se i n s t i t u ­ tio n s a re p r iv a te ly o p e ra te d , th e y have a r i g h t t o s e t up t h e i r own standards o f adm ission o v e r and above th e c lo s e ly a d h e re d -to r e lig io u s requirem ent: hence when placem en t i s r e q u ir e d , u n a c c e p ta b ility t o th e se schools may leave no re so u rce t o which t o send th e d e lin q u e n t y o u n g s te r b u t th e u n r e s tr ic te d s t a t e c o r r e c tio n a l sc h o o ls and th e s t a t e i n s t i t u t i o n s f o r th e m entally * d e fe c tiv e * The p r i v a t e b u t governm ent-supported c h ild - c a r in g i n s t i t u t i o n s ab id e by t h e i r own, o f te n a r b i t r a r y c r i t e r i a o f a c c e p ta b ility *

Thus, th e

la c k o f a few p o in ts i n i n t e l l i g e n c e q u o tie n t may d e b a r a c h ild , may c re a te

a p r o tr a c te d p e rio d o f s ta y i n a tem porary d e te n tio n c e n te r w hile o th e r f a c i l i t i e s a re s o u g h t, and m ight u ltim a te ly v i r t u a l l y n e c e s s ita te p la c e -

1 . Quoted by Edwin J . L ukas, "llore on th e C h ild r e n 's Court and Cognate M a tte r s ,R The Record o f th e A sso c ia tio n o f th e B ar o f th e C ity o f New T o rk , V ol. 3 , No. 8 , Nov. 1948, p . 339* *

Some o b je c tio n s t o p u b lic i n s t i t u t i o n s f o r c h ild r e n (in l i e u o f p r i ­ v a te and s e c t a r ia n a g e n c ie s) which hold much hope o f reso lv in g such d i f f i c u l t i e s c l u s t e r , i n p a r t , about th e m inim ization o f th e r e l i g io u s in f lu e n c e i n th e c h i l d 's l i f e . There i s always th e r e jo in d e r t h a t o u r democracy u n d e rw rite s th e se p ara tio n o f church and s t a t e , y e t where r e lig io u s n e ed s m ust be su p p lied , i f th e s p i r i t u a l guidance f o r 18,000,000 servicem en and women can be m et, so t o o , can th o se o f th e much s m a lle r population i n i n s t i t u t i o n s f o r c h ild r e n .

200

n en t in a s t a te school f o r m ental d e f e c t i r e s .

*

I n a s i m i l a r m anner, in ­

form al "quota system s" c re a te very g re a t o b s t a c l e s f o r c h i l d r e n o th e r than **

white*

Moreover, adm ission of c h ild re n w ith m a n i f e s t e m o tio n a l problem s,

f o r those who a re chronic run-aways (in " o p e n -ty p e " p r o g r a m s ) , o r f o r f i r e s e t te r s i s extrem ely d i f f i c u l t to a rra n g e .

And j u s t o f l a t e ,

th e demand

f o r s t a te tr a in in g school placem ents has b een s o g r e a t , t h a t t h e i r f a c i l i t i e s have been overtaxed and youngsters have had t o re m a in i n te m p o ra ry d e te n tio n much lo n g er than u su al b efo re admission c o u ld b e e f f e c t e d * Faoing th e se handicaps i t i s u n d e rs ta n d a b le t h a t t h e c l i n i c i a n whose re p o rt may serve as a guide to th e c o u r t i n p l a n n i n g f o r t h e young­ s t e r should f e e l discouraged*

Very o fte n th e b e s t c o u r s e t h a t m ight be in ­

d ica te d i s precluded a s , f o r in s ta n c e , in w o rk in g w i t h t h e f a i r l y la rg e number o f Negro P r o te s ta n t c h ild re n who need p l a c e m e n t.

F o r th e m , long-term

f o s t e r home arrangem ents or school placem ents a r e m o st d i f f i c u l t to make. By way o f c o n tra s t, f o r th e p re se n t even th o u g h c o n d i t i o n s a r e f a r from id e a l, Jewish youngsters (num erically a s m a lle r g ro u p ) e n jo y t h e most fa v ­ o rab le p ro sp ects f o r such environm ental changes a n d w h i t e C a th o lic c h ild re n a ls o have a reasonable chance o f placem ent.

Even s o , m ak in g t h e n e cessary

environm ental s h i f t s i s g e n erally d i f f i c u l t t o a r r a n g e a n d comprom ises f a r s h o rt o f id e a l o ften re s u lt*

*

The s itu a tio n d e scrib e d i s n o t u n u su al f o r s e v e r e l y c u l t u r a l l y handi­ capped and em otionally deprived y o u n g s te r s who f u n c t i o n p o o rly on conventional in te llig e n c e t e s t s e s p e c i a l l y t h o s e w h ic h a r e f a i r l y v e rb a l in emphasis*

**

Che r e f le c tio n o f th e o p eratio n of t h i s sy s te m s t r u c k t h e in v e s tig a to r q u ite f o r c e f u lly . During a v i s i t t o t h e S t a t e T r a i n in g School f o r Beys a t Warwick, New Tork, e a rly i n 1 9 4 9 , h e l e a r n e d t h a t approxi­ m ately 70% o f the c u rre n t p o p u latio n o f t h e s c h o o l was N egro. M id-A pril 1950

201 The T reatm ent C lin ic A c tu a lly one o f th e b ig g e s t problem s from th e p o in t o f view o f th e p e rso n n el manning th e c l i n i c i s i t s d i v is io n in to a D iag n o stic and a T re a t­ ment S e rv ic e .

‘W hile a concern about tre a tm e n t and im patience w ith th e s h o rt­

comings o f d ia g n o s is o n ly i n a s e t t i n g in which recommendations cannot a l ­ ways be a c te d upon p e rv a d e s perh ap s a m a jo r ity of th e s t a f f members, f o r th e p r e s e n t , th e T reatm en t S e rv ic e i s in some re s p e c ts an appendage to th e o r ig in a lly e s t a b l is h e d D ia g n o stic C lin ic* Exam ining th e T reatm ent C lin ic more c lo s e ly , a remark by Judge H ill should be r e p o r te d :

n0 u r T reatm ent C l in i c , working on a h ig h ly s e le c tiv e

b a s i s , i s a b le to h a n d le o nly ab o u t 300 c h ild r e n a y e a r.

There a re a t l e a s t

500 more c h ild r e n who sh o u ld re c e iv e t h i s sp le n d id s e rv ic e ." ^

In some

r e s p e c ts , th e s e l e c t i v e in ta k e p o lic y i s a t tim es rela x ed in p a r t under th e p re s s u re o f th e r e a l i t y t h a t i f th e c o u rt does n o t undertake to provide c l i n i c a l tr e a tm e n t f o r th e c h ild , i n a l l lik e lih o o d he w i l l n o t g e t i t .

As

a r e s u l t , y o u n g s te rs who cannot be most e f f e c t i v e l y helped through th e some­ what l im ite d c o u n se lin g c o n ta c ts t h a t th e c l i n i c can provide a re taken on f o r th e ra p y .

A t o t h e r tim e s th e p re s s u re o f th e caseload i s such t h a t i t

i s n e c e ssa ry t o c lo s e in ta k e e n t i r e l y . P a r t o f th e d i f f i c u l t y may be found in th e t r a d i t i o n a l view o f th e way I n which c l i n i c a l s e r v ic e s can be u t i l i z e d by th e c o u rt.

The T reat­

ment C lin ic was s e t up o r i g i n a l l y in 1937 a s a dem onstration u n i t on a pwiwii b u d g et f u r n is h e d by p r iv a te fu n d s.

1. John V. Hi l l , c^» c l t . , p . 73*

A fte r a p erio d d uring which th e re

202

was considerable u n c e rta in ty about money t o c o n tin u e o p e r a tio n s , in 194-6 th e c ity assumed the re s p o n s ib ility f o r f u r n i s h i n g t r e a t m e n t .

At th e moment,

a p a rt from the a d m in istra to r in charge o f a l l c l i n i c a l s e r v ic e s (a h a lf-tim e employee), th e Treatment u n it has i t s own s t a f f o f t h r e e (h a lf-tim e ) psy­ c h i a t r i s t s , fo u r fu ll-tim e supervisory p s y c h i a t r i c s o c i a l w orkers and fo u r fu ll-tim e supervisory p sy c h ia tric s o c ia l w o rk e rs and f o u r f u l l- t i m e c le r ic a l * employees. No p sy ch o lo g ists are o f f i c i a l l y a t t a c h e d t o t h i s u n i t, b u t as most of the cases a re re fe rre d by th e D ia g n o s tic C l i n i c , p sy c h o lo g ic al stu d ie s a re already a v a ila b le .

In a d d i t i o n , T re a tm e n t p e rs o n n e l can arrange

f o r needed a s s is ta n c e from the p s y c h o lo g is ts b y a p p o in tm e n t b u t th e diagnos­ t i c caseload does not o rd in a rily leave much tim e f o r t h i s c o lla b o ra tio n .

It

should a lso be noted th a t no s o c io lo g is t i s em ployed b y th e c l i n i c . While some of th e th e ra p e u tic w ork w ith t h e c a s e lo a d i s done by s t a f f p s y c h ia tr is ts and p sy c h ia tric s o c i a l w o r k e r s , t h e b u lk o f th e t r e a t ­ ment i s c a rrie d on by te n advanced s tu d e n ts who s e r v e on a v o lu n te e r b a sis as field -w o rk placement f o r c re d it tow ards th e M a s te r Ts d e g re e a t th e New Tork School f o r S o c ial Work.

With th e r e c e n t l y a d d e d p r o f e s s io n a l s t a f f ,

c lo s e r supervision i s p o ss ib le , but sin c e t h e s e s t u d e n t s l a c k f u l l e s t t r a i n ­ in g , somewhat more lim ite d treatm ent g o a ls m u st b e s e t .

R e a lly in te n siv e

and long-term th e ra p e u tic commitments a re im peded b y t h e " tu rn o v e r” a ris in g from th e f a c t th a t follow ing two or th r e e c o l l e g e q u a r t e r s th e stu d en t th e ra ­ p i s t s complete t h i s phase of t h e i r t r a i n i n g and l e a v e . Another handicap stems from th e u r g e n t n e e d o f a v e ry la rg e pro­

*

This includes th e two p s y c h ia tr is ts , two p s y c h i a t r i c s o c i a l workers and two stenographers added under a te m p o ra ry g r a n t from th e New Tork Touth Board during 1949,

203

p o rtio n o f th e T reatm ent C lin ic c ase s f o r re m e d ia l tr a in in g in to o l s u b je c ts o f th e sc h o o l c u rric u lu m .

Like o th e r r e s o u r c e s , agencies t h a t can provide

t h i s h e lp i n th e New York a re a a r e s o r e ly burdened so th a t r e f e r r a l o f young­ s t e r s i s d i f f i c u l t ! m oreover, sending c h ild r e n t o another agency i s n o t a l ­ ways an advantageous move from th e p o in t o f view o f th e dynamics o f th e t r e a t ­ ment p r o c e s s .

A much b e t t e r arrangem ent would perm it in d iv id u a l rem edial * t r a i n in g b y & s p e c i a l i s t a ssig n e d to th e T reatm ent C lin ic . Yet th e so re ly

needed re m e d ia l t r a i n i n g i s n o t fu rn is h e d u n d e r c lin ic au sp ices and, i n many «# cases u n d er p r e s e n t school and community c o n d itio n s , i s n o t supplied a t a l l . C lo sely r e l a t e d to o , i 6 th e la c k o f p ro v is io n f o r sp e c ia liz e d a s s is ta n c e f o r c h ild re n w ith d e e p -ro o te d n o n -o rg an ic sp eech d i f f i c u l t i e s concurrent w ith th e p s y c h o th e ra p e u tic p ro c e ss : f o r t u n a t e l y , however, th e p ro p o rtio n of young­ s t e r s r e q u ir in g such a id i s b u t a f r a c t i o n o f th e number who p re s e n t se rio u s s u b je c t d i s a b i l i t i e s a s p a r t o f th e symptom p i c t u r e . I n enum eratin g problem s, a lo n g w ith th e fa m ilia r handicap o f in ­ s u f f i c i e n t c l e r i c a l a s s is ta n c e , m ention sh o u ld be made of th e hindrance to th e smooth o p e ra tio n o f a tre a tm e n t program a r i s i n g from th e shortag e o f o f f ic e sp a c e .

I n th e one and a h a l f f l o o r s o f th e Manhattan Domestic Re­

l a t i o n s C ourt b u ild in g occupied by th e c l i n i c , space i s a t a premium i n the m ornings when th e f u l l p r o f e s s io n a l s t a f f i s p resen t*

Although th e sh o rt­

age e a se s up somewhat i n th e a fte rn o o n s in c e th e p s y c h ia tr is ts and psycholo­ g i s t s o f th e D ia g n o stic C lin ic work h a lf - t im e , more room i s re q u ire d f o r c o n v e n ie n t, c o n f i d e n ti a l c o u n s e lo r - p a tie n t th e ra p e u tic c o n ta c ts.

*

As a m a tte r o f f a c t , th e p s y c h o lo g is ts s e rv in g in the D iagnostic u n it have been tr a i n e d and a re p re p a re d t o a id in t h i s p ro ce ss.

**

AT1 to o f r e q u e n tly , recommendations o f members of th e D iagnostic C lin ic f o r in d iv id u a l rem edial t r a i n i n g a r e made y e t a re n o t implemented.

t

204 The b rig h te r sid e of th e T re a tm e n t C l i n i c p i c t u r e has been r e f e r r e d to re c u rre n tly in the p u b lic p re s s , i n s p e c ie !, a r t i c l e s end in such s t a t e ­ ments as t h a t of Judge H ill:

"Follow -up o f o u r c a s e s in d ic a te s an a sto n ­

ish in g success in 70£ of them thus t r e a t e d .

The f i g u r e i s most g r a tif y in g

when you r e a liz e th a t the C lin ic i s r e c e i v i n g t h e m o st d i f f i c u l t cases t h a t come b efo re the c o u rt, cases where i n e a c h i n s t a n c e , t h e c h ild would have been in s titu tio n a liz e d were i t n o t f o r t h e s e r v i c e s o f th e C l i n i c . M o r e c r i t i c a l a p p ra is a ls of th e work o f any c o u r t t r e a t m e n t c l i n i c weigh i t s success l e s s in terms of recidivism a n d more i n te r m s o f the progress made towards elim in a tin g th e various s o u rc e s o f m a la d ju s tm e n t in th e c h i l d 's general fu n ctio n in g .

By these b ro a d e r s t a n d a r d s , i t i s u n lik e ly t h a t a 70£

success fig u re i s r e a l i s t i c , y e t even s o , a s a t r e a t m e n t agency a very c r e d i t ­ ab le job i s being done.

Moreover, among c o m p a ra b le c l i n i c s , the Hew Tork

u n it l i e s in the fo re fro n t of th o se w h ich r e c o g n iz e t h a t the p e rs o n a lity p ro b ­ lems o f th e c h ild are strongly ro o te d i n d i f f i c u l t i e s i n in te rp e rs o n a l r e ­ la tio n s h ip s , hence a tta c k the problem o f t h e c h i l d n o t i n is o la tio n b u t in p a r t by working w ith a p aren t in c o n c u r r e n t t h e r a p y . In a d d itio n to being a s e r v i c e a g e n c y , a c e r t a i n amount of r e s e a r c h has been c a rrie d on in th e Treatm ent C l i n i c b y t h e s u p e rv is in g p s y c h i a t r is t — p a r tic u la r ly with group therapy.

A c t u a l ly , t h i s w ork h a s had a t r i p l e func­

tio n since beyond serving as a t h e r a p e u t i c t o o l f o r t h e p a tie n ts , and i n a d d itio n to i t s research value, i t was a s w e l l a d i d a c t i c process which th e ■* p s y c h ia tric s o c ia l work tra in e e s c o u ld a c t u a l l y o b s e r v e and d is c u s s . O ther research done in the c lin ic has been l a r g e l y c o n f i n e d t o t h a t conducted by stu d e n ts doing d is s e rta tio n s i n p a r t i a l f u l f i l l m e n t o f academic re q u ire m e n ts.

1.

John W. H ill, 0£. c i t . , p . 68.

*

Observation and recording of g ro u p p s y c h o th e ra p y i e made p o ssib le by a one-way (m irror) glasB s c re e n and a w ir e r e c o r d e r .

205 G eneral Problem s A number o f problem s o f a r a t h e r g e n eral n a tu re co n fro n t th e p e r ­ so n n e l o f b o th th e D ia g n o stic and T reatm ent u n its and may be mentioned to ­ g e th e r ,

Among th e forem ost I s th e l a c k o f a more e f f e c tiv e procedure f o r

th e s e l e c t i o n o f e a s e s from th e many a p p earin g In C h ild re n 's C ourt,

Members

o f th e s t a f f have f o r some tim e been concerned about th e haphazard b a s is on w hich c h ild r e n h a re been chosen f o r c l i n i c a l r e f e r r a l .

Since no s t a f f

member i s p r e s e n t a t th e h e a rin g s i n which th e y o u n g ste rs f i r s t appear be­ f o r e th e c o u r t , th e r e i s v e ry l i t t l e o p p o rtu n ity to d e te c t immediately th o se c h ild r e n who seem t o be in need o f tr e a tm e n t on th e b a s is of c l i n i c a l impres­ s io n s ,

The d e c is io n to make a r e f e r r a l r e s t s w ith th e ju d g e, o r may come

i n re s p o n se t o prom pting from a p ro b a tio n o f f i c e r .

As a r e s u l t , o th e r than

f o r th e v e ry o b v io u sly d is tu r b e d o r m e n ta lly d e fe c tiv e , th e youn g sters who may seem m ost i n need o f c l i n i c a l stu d y to a m ental h y g ie n is t may n o t be r e f e r r e d w h ile c h ild re n w ith a b a s i c a l l y sounder p e rs o n a lity s tr u c tu r e a re s e n t t o th e c l i n i c on th e b a s i s o f b e h a v io r during t h e i r i n i t i a l c o u rt ap­ p e a ra n c e . To t h a t en d , a com prehensive screen in g plan has been dev ised and su b m itte d t o th e a d m in is tra tio n by members o f th e c l i n i c a l s t a f f t h a t would p la c e t r a i n e d p s y c h ia tr ic s o c ia l w o rk ers a t key p o in ts in th e p ro b atio n program t o p ro v id e f o r a review o f a l l c a se s on which in v e s tig a tio n s a re made.

I n t h i s way, a l l c h ild re n seem ingly most in need o f c l i n i c a l study

l a r g e ly on th e b a s i s o f background d a ta could more re a d ily be picked up and s e n t cm t o o t h e r members o f th e c l i n i c a l team f o r f u r th e r e v a lu a tio n .

As

p a r t o f th e p r o c e s s , th e p s y c h o lo g is t would have n e x t c o n ta c t w ith th e c h ild . I f on th e s t r e n g th o f th e p s y c h o lo g ic a l study (in c lu d in g In terv iew and t e s t d a t a ) , p s y c h i a t r i c exam ination i s c o n sid e re d to be re q u ire d , such a ste p

206 would be scheduled.

C lin ic a l a d v ic e w ould t h u s b e na.de a v a ila b le to th e

co u rt f o r cases considered by c l i n i c i a n s t o b e m ost i n need o f s e rv ic e s , and a nore snoothly flowing tre a tm e n t p r o c e s s w o u ld b e a s s u re d f o r those young­ s te r s f o r whom o u t-p a tie n t p sy c h o th era p y i s i n d i c a t e d .

N a tu ra lly , th e p l a n

e n ta ils g re a t expansion o f th e c l i n i c a l s t a f f , a n d , i n sone re s p e c ts , r e o r ­ g an ization o f co u rt procedure.

As a r e s u l t , w h ile some support e x is ts fro m

q u a rte rs o th e r than the c l i n i c , n e a r - te r m a d o p tio n d o e s n o t appear l i k e l y . Several o th er developm ents c o n c e rn in g t h e work o f th e c li n i c th ro w l ig h t on p re se n t p ra c tic e s and d i r e c t i o n s f o r p r o j e c t e d improvements.

A

good proportion of the c l i n i c a l s t a f f (m o st o f whom a r e r e la tiv e ly r e c e n t employees and w ithout ten u re and c e r t a i n C i v i l S e r v ic e p riv ile g e s ) a re con­ cerned about th e d iag n o stic o r i e n t a t i o n t h a t s t i l l p e r s i s t s in th e c o u rt and affectB th e c li n i c a l program .

They r e c o g n i z e t h a t even th e d ia g n o s tic

co n tacts w ith th e p a tie n t, d e s p ite t h e a u t h o r i t a r i a n s e t ti n g , can have con­ sid e ra b le meaning f o r some p a t i e n t s an d t h a t s t r i n g e n t l y lim itin g th e se sessio n s reduces t h e i r p o te n tia l v a l u e .

T h e re a r e tim e s , f o r in s ta n c e ,

when th e in v e s tig a to r and o th e rs h a v e b e e n a b l e t o e s t a b l is h , perhaps a f t e r i n i t i a l d i f f ic u lt y , a good r e l a t i o n s h i p w i t h a c h i l d whose co n ta cts w ith people — e sp e c ia lly p a re n ts, t e a c h e r s a n d a u t h o r i t y f ig u r e s — have been unrewarding or even trau m atic.

I n t h e c o u r s e o f a few c lin ic v i s i t s , su ch

a c h ild who fin d s th a t an a d u lt c an b e w arm , a c c e p t in g and resp o n siv e, c a n re a c t to th e term ination of c l i n i c a l c o n t a c t s w ith a f e e lin g o f lo s s o r r e je c tio n .

"Dropping" th e p a t i e n t a f t e r e x a m in a tio n jeo p a rd iz es w hatever

fav o rable rap p o rt o r tra n s fe re n c e t h a t m ig h t h a v e b e en e sta b lis h e d t h a t i s o f c ru c ia l value in th e p ro cess o f r e h a b i l i t a t i o n .

A f te r a l l , i t i s p re ­

c is e ly t h i s patient-w orker r e l a t i o n s h i p t h a t i s so im p o rtan t in th e reed u ­ c atio n o f a c h ild :

As Aichhom h a s show n:

207 You have seen t h a t a c h a r a c t e r change in th e d e lin q u e n t means a change i n h i s ego id e a l* This o ccu rs when new t r a i t s a r e ta k e n o v e r by th e in d iv id u a l* The source o f th e s e t r a i t s i s th e w o rk e r. He i s th e im p o rtan t o b j e c t w ith whom t h e d i s s o c i a l c h ild o r y o u th can re** t r i e v e th e d e f e c tiv e o r n o n - e x is te n t i d e n t i f i c a t i o n and w ith whom h e c an e x p e rie n c e a l l th e th in g s in which h i s f a t h e r f a i l e d him* W ith th e w orkerfs h e lp th e y o u th a c q u ire e th e n e c e s s a r y f e e lin g r e l a t i o n to h i s companions which e n a b le s him t o overcome th e d i s s o c ia l tr a its * .• A p a rt from t h i s v i t a l l o s s i n th e th e r a p e u tic a lly c r i t i c a l tr a n s ­ f e r e n c e , th e p r e v a i l i n g system a t t h e c l i n i c a ls o s a c r i f i c e s a fo llo w -u p program and g r e a t l y cu rb s r e s e a r c h by s t a f f members.

Y oungsters seen in

t h e D ia g n o s tic C l in i c do n o t r e t u r n t o th e c l i n i c f o r th e m ost p a r t u n le s s a r e c h e c k i s recommended t o th e c o u r t o r f u r t h e r tro u b le w ith th e law l e a d s t o a new h e a r in g a t w hich t h e c o u r t r e q u e s ts a d d itio n a l stu d y w ith a view t o a d i f f e r e n t d i s p o s itio n *

Of c o u rs e , th e s t a f f i s so busy w ith

c u r r e n t c a s e s t h a t fo llo w -u p c o n t a c t s w i a c lo s e d c a se s could b a re ly be * f i t i n t o th e sc h ed u le * N e v e r th e le s s , th e la c k o f a follo w -u p procedure means t h a t o r d i n a r i l y th e c l i n i c i a n d o e s n o t know w hat happens t o th e p a t i e n t a f t e r a recom m endation h a s b een su b m itte d to th e c o u rt u n le s s th e c h i l d s h o u ld happen to r e t u r n t o t h e c l i n i c a s a tre a tm e n t c a s e .

The

a c t u a l im p le m e n ta tio n o f c l i n i c a l s u g g e s tio n s — i f a ccep ted by th e c o u rt — i s p la c e d i n t h e hands o f th e p r o b a tio n w orker who may o r may n o t in f o m t h e c l i n i c members o f th e p r o g r e s s o f th e c h ild *

In t h i s way, a g r e a t

d e a l o f v a lu a b le in fo rm a tio n i s l o s t t h a t m ight be im p o rtan t i n p lan n in g f o r o th e r e a s e s .

1*

A ugust A ic h h o ra , Wayward Y o u th , p . 234*

*

P e rh a p s t h i s i s a problem r a t h e r s p e c i f i c t o a la r g e community l i k e New York* b u t i n a c e r t a i n p r o p o r tio n o f th e c a se s th e u n a v a i la b i li t y o f d a ta from h o s p i t a l s , o t h e r s o c i a l a g e n c ie s , and th e Bureau o f C hild G uidance makes f o r a c e r t a i n amount o f d u p lic a tio n o f e f f o r t .

208 S im ila rly , a s an agency d e d i c a t e d p r i m a r i l y to p a tie n t s e n d e e , and under the p ressu re of an u n r e l e n t i n g c a s e l o a d , tim e i s n o t a v a ila b le f o r most s t a f f members to conduct p r o f e s s i o n a l r e s e a r c h .

Im portant n o t

only in th e v a lid a tio n of th e w ork o f t h e c l i n i c i a n , b u t a ls o as a f o r c e f o r p ro fe s sio n a l growth, in r e c e n t y e a r s r e s e a r c h conducted under c l i n i c au sp ices has been p r a c tic a lly c o n f in e d t o one o r tw o p ro je c ts in th e T r e a t­ ment C lin ic and to stu d en t i n v e s t i g a t i o n s *

Some members of th e s t a f f h av e

been a b le to engage in re s e a rc h , b u t t h i s h a s b e e n impeded by th e f a c t th a t th ey did n o t have th e time n o r t h e c a s e s a v a i l a b l e to them a t th e c lin ic .

At a s t a f f conference i n A p r i l 1 9 5 0 , how ever, t h i s tre n d was r e ­

viewed and th e need fo r re se a rc h c o n d u c te d a s a r e g u l a r c lin ic fu n c tio n was acknowledged by a l l p a r t i c i p a n ts *

A c o m m ittee h as been s e t up to

study and f a c i l i t a t e th e conduct o f r e s e a r c h i n t h e c l i n i c . Another l a t e change o c c u r r e d w i t h t h e re-e x am in atio n of th e u s e o f th e c lin ic a s a tra in in g c e n t e r .

I n t h e p a s t , b e s id e s p s y c h ia tric

s o c ia l work tr a in e e s , p s y c h o lo g ic a l i n t e r n e s h a v e appeared on the scene * from tim e to tim e. Ho use i s made o f t h e c l i n i c a s a tra in in g c e n te r e ith e r f o r c h ild p s y c h ia tr is ts o r c l i n i c a l p s y c h o lo g is ts a t p re s e n t.

W hile

th e volume of work f o r each i n d i v i d u a l s t a f f member can be advanced in e x p lan atio n , t h i s was d e sig n ated a s a n o t h e r a r e a f o r e x p lo ra tio n w ith a view to the u ltim a te in tro d u c tio n o f a r e g u l a r t r a i n i n g program a t l e a s t f o r c li n i c a l p sy ch o lo g ists. The c lin ic could a ls o e x te n d i t s

*

s e r v i c e s by reaching o u t i n t o

As a m atter of f a c t , th e i n v e s t i g a t o r w as a b l e t o b rin g to the c l i n i c and t r a in a number o f i n t e r n e s , b u t t h e s e w ere s t r i c t l y tem porary, v o lu n te er in te m e s h ip s w ith o u t a r e g u l a r program and form al univ­ e r s i ty a f f i l i a t i o n .

209 th e community to a g r e a te r e x te n t th an i t does a t p re s e n t.

While in d iv id u a l

s t a f f members serv e w ith l o c a l g ro u p s, p a re n ts' o rg a n iz a tio n s , re p o r t to pro­ f e s s i o n a l o r g a n iz a tio n s , w r ite a r t i c l e s , and teach a t u n i v e r s it i e s , s t a f f members below th e a d m in is tr a tiv e le v e l a re n o t encouraged to fu n c tio n in th e c l i n i c beyond t h e i r c o n ta c t w ith th e c ase lo ad .

While they have a l l they

can do t o keep up w ith th e c a s e s , th e c li n i c could serve much more valuably a s a v i t a l f o r c e i n th e e d u c a tio n o f th e community f o r curbing delinquency and m en tal d is e a s e i f r e s p o n s i b i l i t i e s f o r p u b lic r e la tio n s work were shared by o th e r s t a f f members. As p a r t o f th e p ro c e s s o f reach in g in to th e community a l l members o f th e c l i n i c a l s t a f f f e e l v ery k eenly th e need f o r p ro viding help f o r th e c h ild r e n b e fo re t h e i r problem s become so severe t h a t they re q u ire th e a t t e n t i o n o f th e ju v e n ile c o u r t and c l i n i c .

For t h i s reason th e e x ten sio n

o f m en tal h e a l th and a d ju stm e n t s e rv ic e s in sch o o ls, through community g u id ance c e n te r s and l o c a l h o s p i t a l s i s stro n g ly fa v o re d .

In th e c o u rt

s e t t i n g p r o p e r , b e s id e s p ro v id in g b e t t e r se rv ic e s f o r d e lin q u e n ts, ex­ te n s io n o f tre a tm e n t to th e n e g le c te d c h ild re n i s regarded im portant a s a p re v e n tiv e m easure.

I n a d d it i o n , recognizing th e ro le o f p a re n ts as

c o n tr i b u to r s t o th e em otional h e a l th o r pathology o f th e c h ild , s t r e s s on g r e a t e r s e r v ic e to p a re n ts i s fa v o re d both to improve t h e i r own a d ju s t­ ment and t o p ro v id e a b e t t e r atsiosphere f o r th e c h ild re n i n th e home. D is p o s itio n s R e tu rn in g from th e exam ination o f th e P s y c h ia tr ic C lin ic and gen­ e r a l problem s a f f e c tin g i t s o p e ra tio n to th e process by which a more o r l e s s -ty p ic a l d e lin q u e n t i s se rv e d by th e C h ild re n 's Court in lew T ork, i t w i l l b e r e c a l l e d t h a t fo llo w in g th e p ro b atio n in v e s tig a tio n and r e f e r r a l

210 to th e D iagnostic C lin ic , a r e p o r t i s s e n t t o t h e judge p re sid in g a t a second hearing.

*

Wien a f u l l p s y c h i a t r i c s tu d y has been made, th e r e ­

p o r t i s w ritte n by th e p s y c h i a t r i s t i n c o r p o r a t i n g th e p sy ch o lo g ic al f i n d ­ ings*

Cases re fe rre d f o r p s y c h o lo g ic a l s tu d y o n ly a re w ritte n up and

recommendations are made b y t h e p s y c h o lo g is t* The second h e a rin g i s t h e one a t w h ich d is p o s itio n i s o r d i n a r ­ i l y planned assuming t h a t ev ery o n e n e e d e d i s p r e s e n t and the d e s ir e d i n ­ form ation about the c h ild and t h e f a m ily can b e g athered in tim e.

B e s id e s

th e judge, a stenographer and c o u r t a t t e n d a n t , th e people fig u rin g i n t h i s hearing are th e c h il d , h i s f a m i l y , and t h e p ro b atio n o f f i c e r .

At

tim e s, in te re s te d agency r e p r e s e n t a t i v e s may b e p re s e n t, and c l i n i c a l personnel a lso have been c a l l e d u p o n .

W ith t h e recommendations o f t h e

p ro b ation o f f ic e r and the c l i n i c a t h a n d , t h e judge u su a lly d ecid es on a treatm ent plan a f t e r some f u r t h e r c o n t a c t w ith th e c h ild and p a re n ts * In evolving a d i s p o s i t i o n p l a n , some o f th e C h ild re n 's C o u rt judges who have c o n sid era b le r e s p e c t f o r t h e c l i n i c and r e f e r numerous cases f o r d iag n o stic and t r e a t m e n t s e r v i c e s , can be r e lie d upon to f o l lo w through on the plan of a d ju s tm e n t r e c o m m e n d e d .

U n fo rtu n ately , o th e r s d i s ­

p la y l i t t l e understanding o f t h e c l i n i c a n d e v e n l e s s use f o r i t *

As a

r e s u l t , in some in s ta n c e s , t h e r e i s a w ide b r e a c h between th e j u d i c i a l and the c lin ic a l p o in ts o f v ie w .

S in c e t h e u l ti m a t e d is p o s itio n o f t h e

p e titio n involving th e c h ild l i e s w ith t h e ju d g e , c li n i c a l recommenda-

*

The r o ta tio n of judges i n d i f f e r e n t boroughs and p a r ts of th e D om estic R elations Court i n t e r f e r e s i n some c a s e s w ith c o n tin u ity a s a case may be heard f i r s t by on e $udge and disp o sed of by a n o th e r . The system i s n o t e n t i r e l y w ith o u t c e r t a i n advantages, how ever.

211 t i o n s may m erely be f i l e d and fo rg o tte n *

D esp ite o p p o sitio n and sk ep ticism

i n some j u d i c i a l and o th e r q u a r t e r s , though, th e c o u rt c li n i c has expanded n o t o n ly i n p e rs o n n e l b u t a l s o i n i t s in flu e n c e i n shaping th e f i n a l p lan f o r th e c h ild .

*

N e v e rth e le s s , h e a r in g s a r e o c c a s io n a lly se iz e d upon a s an oppor­ t u n i t y f o r p re a c h in g a t o r c a j o l i n g th e c h ild in a p sy c h o lo g ic a lly un­ sound manner*

While l e c t u r e s from th e bench on b e in g la w -a b id in g , r e s p e c t­

i n g p a r e n t s , showing concern f o r r e l i g i o u s o b lig a tio n s , keeping away from g an g s o r from se x u a l a c t i v i t y may have a c e r ta in i n t e l l e c t u a l im pact on t h e c h i l d , th e r e - e d u c a tiv e p r o c e s s i s doomed to f a i l u r e i f i t i s c o e rc iv e , p i tc h e d on an i n t e l l e c t u a l p l a n e , and n o t geared t o th e unconscious prompt­ in g s and th e e m o tio n al n e ed s o f t h e ch ild *

T h rea ts o f punishm ent —

u s u a l l y confinem ent i n c o r r e c t i o n a l sch o o ls a re n o t in fre q u e n tly employed w ith an added t w i s t o f punishm ent t o p a re n ts — a l l o f which may add to t h e trau m a t h a t en v elo p s t h e c o n ta c t w ith th e c o u rt and reduces th e c h i l d 's a c c e s s i b i l i t y t o help*

Of c o u rs e such courtroom 1perform ances a re f o r tu n a te ­

l y n e i t h e r i n v a r ia b le n o r th e g e n e r a l p a tt e r n , and b e fo re le a v in g , th e c h i l d may even have made a wholesome human c o n ta c t w ith an a u th o r ity f ig u r e .

*

Schm ideberg h as s t r e s s e d t h e im p o rtan ce of re a lis m among judges who s tr o n g ly fa v o r c l i n i c a l tr e a tm e n t: I t i s t o be hoped t h a t i n tim e m a g is tra te s w i l l r e a l i z e b e t t e r th e p o s s i b i l i t i e s a s w e ll a s th e d i f f i c u l t i e s o f p sy ch o th erap y and u n d e rsta n d t h a t i t i s i n th e b e s t i n t e r e s t o f th e community t o cure a d e lin q u e n t r a t h e r th a n t o send him t o some i n s t i t u t i o n from which he i s bound t o emerge s o o n e r o r l a t e r and where he has to be su p p o rte d by o th e rs * B u t i t must be understood t h a t in o r d e r t o a c h ie v e c u re s th e t h e r a p i s t must have tim e and fa v o r a b le c o n d itio n s f o r tre a tm e n t. ( M e litta Schm ideberg, "Some P r a c t i c a l Problem s in th e Treatm ent o f D e lin q u e n ts ," The P s y c h ia tr ic Q u a rte rly SttPPleweat, P a r t 2 , 191-9, p . 3 ) .

2X2 I f a l l re p o rts are a v a ila b le and t h e p a r e n t s d o n o t f a l l to ap p ea r, g e n e r ­ a lly the judge can announce t o t h e c h i l d how s o c ie ty sees f i t to h e lp h im . According to Judge H i l l , d i s p o s i t i o n s in delinquency c a s e s c u r r e n t ­ ly r e s u lt in commitment f o r a b o u t 20% o f t h e y o u n g sters and p ro b a tio n f o r 65J6*1 Of the l a t t e r , a c e r t a i n p r o p o r t io n may be re fe rre d to th e c o u r t 's Treatment C lin ic , to o th e r r e s o u r c e s f o r o u t - p a t i e n t psychotherapy, m e d ic a l a id , in d iv id u alized rem edial t r a i n i n g , a s w e ll a s fo r o th e r h e lp w h ile t h e c h ild i s being supervised by a p r o b a tio n o f f i c e r .

Child guidance s e r v i c e s

such as those made a v a ila b le by C a th o lic C h a r i t i e s , the Community S e r v ic e Society, the Jewish Board o f G u a rd ia n s, s e v e r a l lo c a l c o lle g e s, a s w e l l a s th e Board of Education a re u t i l i z e d t o t h e e x te n t to which t h e i r h eav y c a s e ­ loads perm it.

Making c o n ta c ts w ith a g e n c ie s i n the community t h a t a r e t o

play a p a rt in improving th e a d ju s tm e n t o f th e c h ild i s th e r e s p o n s i b i l i t y of the probation s t a f f .

W hile r e l a t i v e l y few o f th e p resen t group o f p r o ­

b a tio n o ffic e rs have t h a t c o m b in a tio n o f p e r s o n a l i ty c h a r a c t e r i s t i c s , ex ­ perience and tra in in g t h a t a llo w t h e p e r i o d o f probation to produce m o st f r u i t f u l re-educative r e s u l t s , some o f t h e s t a f f have enthusiasm f o r t h e i r work and p o te n tia l f o r more a d e q u a te d e v elo p m e n t.

With a d d itio n a l an d b e t t e r

equipped probation c o u n se lo rs, c o n ta c t s w ith th e youngsters under s u p e r ­ v isio n could be more fre q u e n t and m ore m e a n in g fu l, and would ta k e on t h e ch aracter of th e high l e v e l , i n t e n s i v e c asew o rk re a lly req u ire d .

2

1 . John W. H ill, 0£ , c i t . . p . 6 5 . 2 . In "Probation and th e J u v e n i le D e l in q u e n t," Reinemann has a p tl y sum m arized the p o sitiv e valu es o f p r o b a tio n s " I t i s th e most i n d i v i d u a l i s t i c fo rm of treatm ent; i t a p p li e s t h e m ethod o f s o c ia l case work and u s e s t h e co n stru ctiv e valu es o f a u t h o r i t y ; i t le a v e s the c h ild in i t s n o rm a l home surroundings; i t e n l i s t s th e h e lp o f community re s o u rc e s ; i t i s not considered p u n itiv e and i s t h e r e f o r e fre e of s o c ia l s tig m a ." The Annals o f th e American Academy o f P o l i t i c a l and S o cial S c ie n c e , J a n ­ uary 1949, p . 119.

213

G e n e ra lly , t h e a v e ra g e p e rio d o f p ro b a tio n I s about s ix months. I f d u r in g t h i s tim e t h e c h i l d a d j u s t s reaso n ab ly w e ll, a tte n d s sc h o o l regu­ l a r l y , a v o id s g e ttin g i n t o f u r t h e r d i f f i c u l t i e s w ith th e p o lic e , and re ­ p o r t s on schedule t o t h e p ro b a tio n o f f i c e r , he i s l i k e l y to be d isch arg ed from p ro b a tio n a t a l a t e r h e a r in g .

T reatm ent undertaken c o n cu rren t w ith

p r o b a tio n may be c o n tin u e d , how ever, b u t a t l e a s t th e c h ild i s f r e e o f the o b l i g a t i o n s o f p ro b atio n *

I f c o n d itio n s a re somewhat clouded and he does

n o t seem t o have shown th e e x p ec te d improvement, th e judge may th en decide t o c o n tin u e p ro b a tio n f o r an a d d i t i o n a l p e rio d .

Those y o u n g sters who v io ­

l a t e t h e c o n d itio n s o f p r o b a tio n p e rh a p s through n o n -atten d an ce a t school, f a i l u r e (w ith o u t good re a s o n ) t o keep appointm ents w ith p ro b atio n o f f ic e r s , by b e in g p ick e d up by th e p o lic e f o r new o ffe n s e s , o r p o s s ib ly because of a d v e rs e developm ents i n t h e home s i t u a t i o n , may f in d t h a t commitment may b e o rd e re d i n l i e u o f p r o b a tio n . The problem o f a rra n g in g lo n g -te rm care and re -e d u c a tio n f o r New T ork c h ild r e n has a lre a d y b een d is c u s s e d i n some d e t a i l .

I f a n y th in g , con­

d i t i o n s do n o t seem t o be im proving b u t r a t h e r becoming somewhat w orse. Judge m i l m entions b u t tw o s t a t e i n s t i t u t i o n s b e sid e s th e twenty p r iv a te a g e n c ie s which a c c e p t d e lin q u e n t c h ild r e n .

F req u en tly c h ild re n re q u irin g

r a d i c a l en vironm ental change m ust rem ain i n th e community i n grav ely inade­ q u a te homes f o r la c k o f f a c i l i t i e s .

Judge S io h er c a l l s a tte n tio n to an un­

f o r t u n a t e m isp laced em phasis w hich i s i n p a r t re s p o n sib le f o r t h i s s itu a ­ tio n :

" I t i s d o u b tle s s n o t g e n e r a lly r e a liz e d t h a t alth o u g h th e S ta te of

New York la v is h e s enormous sums on th e e re c tio n and m aintenance o f p en al i n s t i t u t i o n s f o r a d u l t c r i m in a l s , d is p ro p o r tio n a te ly l i t t l e p ro v isio n i s made by i t f o r th e tre a tm e n t o f d e lin q u e n t c h i l d r e n . . . L u k a s has observed

1.

D udley F . S ic h e r, q u o ted i n Edwin J . Lukas, oj>. d t * . p . 339.

2U su ccin ctly th a t" ..* f a c i l i t i e s f o r e v en p e rfu n cto ry custody o f d e li n q u e n t s s t e r i l e as th a t may be a s a r e h a b i l i t a t i v e procedure, are o f te n so o v e r­ crowded o r, as a r e s u l t o f h i g h l y s e l e c t i v e intake p o lic ie s , s o i n a c c e s s i b l e to the Court, th a t th e y may a s v e i l b e n o n -e x is te n t."

For d e p e n d e n t and

neglected children th e s i t u a t i o n i s l i t t l e b e t t e r p a r t i a l l y b e c a u s e t h e r e has been, according t o Ju d g e H i l l , a re d u c tio n in th e l a s t s ix o r se v en y ears in the number o f p r i v a t e i n s t i t u t i o n s which c a n y on p la c e m e n t work f o r these c h ild ren . Children who have b e e n p la c e d o r c o a a itte d nay have f u r t h e r con­ t a c t with the court i f t h e i n s t i t u t i o n re q u e s ts th a t a change o f p la c e m e n t be arranged o r, as happens a t t i m e s , th e c h ild runs away and re-co m m itm en t i s again necessaxy.

L ik e w is e , y o u n g s te r s who have been d isc h a rg e d from

probation or those who have b een r e l e a s e d from c o rre c tio n a l s c h o o ls who become Involved in su b se q u e n t o f f e n s e s p r i o r to the age of s i x t e e n , may again fig u re on co u rt c a l e n d a r s .

Of th e cases appearing in c o u r t a t any

tim e, youngsters w ith p r e v io u s c o u r t r e c o rd s e ith e r as n e g le c te d o r de­ lin q u en t children amount t o no s m a ll p ro p o rtio n of th e t o t a l , b u t t h e i n ­ v e stig a to r believes t h a t t h e r e h a b i l i t a t i v e work i s a t l e a s t a s s u c c e s s ­ fu l as th a t of other re a s o n a b ly co m parable ju v en ile c o u rts .

L e s t t h e im­

p ressio n given th a t th e c o u r t i s c o n c e rn e d only w ith delinquency c a s e s , i t should be remarked a g a in t h a t a s u b s t a n t i a l portion of th e c a le n d a r i s de­ voted to hearing n e g le c t p e t i t i o n s , a rra n g in g fo r commitment f o r m e n ta lly d efectiv e youngsters, s e r v in g c h i l d r e n who are m aterial w itn e s se s an d a l s o

1.

Edwin J . Lukas, op. c l t . . p . 3 3 7 .

2.

(>£. c i t . . p. 72-

215 h andicapped i n d i v i d u a l s up t o tw enty-one y e a rs of age.

As Iynn h as pointed

o u t, to o , "In c e r t a i n in s ta n c e s i t has j u r i s d i c t i o n over proceedings to de­ te rm in e th e r i g h t f u l cu sto d y o f c h ild re n .^ S in c e th ro u g h th e example o f th e d e lin q u e n t c h ild th e work of the c o u r t can b e s t be i l l u s t r a t e d and e s p e c ia lly sin c e th e s e c h ild re n a re the fo c u s o f th e r e s e a r c h , th e h an d lin g o f delinquency p e t i t i o n s has been tre a t­ ed i n f u l l e s t d e t a i l .

F in a lly , l e s t th e c r i t ic i s m s o f d e te n tio n conditions,

c o u rt p ro c e d u re s , p e r s o n n e l, and e s p e c ia lly th e c l i n i c a l s e rv ic e s be con­ s tr u e d a s m eaning t h a t th e in v e s tig a to r ta k e s a dim view of th e serv ices pro­ v id e d i n New York (by com parison w ith th o se in o th e r c i t i e s ) , he wishes to c a u tio n a g a i n s t any su ch in fe re n c e .

R ath er h i s rem arks a re in ten d ed to point

o u t d i r e c t i o n s f o r im provem ent which, i f im plem ented, would le a d to maximal s e r v ic e on a v i t a l f r o n t - l i n e o f democracy. Summary P a r tic ip a n t- o b s e r v a tio n s in th e Domestic R e la tio n s C ourt and i t s P s y c h i a tr i c C lin ic h av e p o in te d o u t c e r t a i n d i s t i n c t l im i ta t io n s .

With ju ris­

d i c t i o n e x c lu s iv e o n ly t o age f i f t e e n and shared f o r s e rio u s o ffe n se s for one more y e a r t h e r e a f t e r , end lac k in g s u f f i c i e n t p e rso n n el o f o u tstan d in g caliber, a s s i s t a n c e t o youth h a s f a l l e n sh o rt o f what m ight w e ll be p ro v id ed .

The

P s y c h i a tr i c C l i n i c , w h ile i t i s an im p o rtan t arm o f th e c o u rt i s try in g to do a v ery b ig job a g a i n s t tremendous odds.

I t i s handicapped in i t s work by

la c k o f re s o u rc e s i n th e community n e c e ssa ry f o r im plem entation o f psychiat­ r i c recom m endations, and moreover i s under c o n sta n t p re s s u re to produce 4 l a r g e number p f c a s e s i n which e s s e n tia lly d ia g n o s tic s e rv ic e r a th e r than

1.

R obert P . Iy n n , "The C h ild re n ’ s C o u rt," The Record, o f th e Association o f th e B ar o f th e C ity o f New York, February 194*5, P- 63.

216 treatm ent has been r e n d e r e d .

F a r t h e r , n o t only the c l i n i c a l p s y c h o l o g i s t s ,

but a l l of the p e rso n n e l u n d e r th e s e conditions are obliged t o f u n c t i o n somewhat le s s than m ax im ally . Unlike a s u b s t a n t i a l number o f larg e c i t i e s elsew h e re, th o u g h , the c lin ic i s able t o p ro v id e some s e rv ic e s fo r a t l e a s t one i n e v e r y f i v e youngsters coming b e f o r e t h e c o u r t and can carry through i n t o a l i m i t e d treatm ent re la tio n s h ip a b o u t 20% o f th e s e .

The promising e x p a n sio n s i n

s t a f f and changes t h a t have ta k e n p la c e in the p a st few y e a r s , c o u p le d w ith an awakened s e n s i t i v i t y t o th e n eed f o r research and p a r t i c u l a r l y f o r t h e extension of the p s y c h o th e ra p e u tic program bode w ell f o r th e d e lin q u e n t youth as well as f o r th e community o f New York.

CHAPTER V III CONCLUSIONS AND RECOMMENDATIONS

As h a s b e e n show n, under th e im petus o f an em erging humani­ t a r i a n ! sm and a r a p i d l y d e v e lo p in g s c i e n t i f i c a t t i t u d e , th e ju v e n ile c o u r t came i n t o b e in g i n Chicago i n 1899, and w ith in te n y e a rs was fo l­ low ed by a p s y c h i a t r i c c l i n i c In te n d e d to equip th e c o u rt w ith a f u lle r p i c t u r e o f th e p ro b lem c h il d so t h a t m ost e f f e c t i v e r e h a b i l i t a t i o n could b e p la n n e d .

The i d e a o f th e ju v e n ile c o u rt sp read r a p id ly and to seme

e x t e n t so d id t h a t o f t h e ju v e n ile c l i n i c which gain ed momentum fro n an awakened i n t e r e s t i n m e n ta l hygiene i n th e f i r s t q u a r te r o f th e century a s w e ll a s from an im p o rta n t j o i n t D em onstration Program .

Beginning with

j u v e n i l e c o u rt c l i n i c s , th e fo c u s o f th e D em onstration Program sh ifte d t o community c h i l d g u id a n c e s e r v ic e s which today have f a r outpaced th e ir j u v e n i l e c o u rt c o u n t e r p a r t s .

Y et d e s p ite th e v i c i s s i t u d e s o f depression

and w a r, a p p ro x im a te ly tw e n ty l a r g e r m e tro p o lita n c e n te r s a re equipped w ith t h e i r own j u v e n i l e c o u r t p s y c h ia tr ic c l i n i c s w hich, a lth o u g h they a r e n o t e n t r u s t e d w ith t h e f i n a l d i s p o s i t i o n , sh a re s i g n i f i c a n t l y in the work o f p la n n in g t h e r e c o n s tr u c tio n o f th e y o u n g ste rs a p p e a rin g before th e c o u r t . F o r th e p r e s e n t , th e s e a g en c ie s a r e d iv id e d ab o u t evenly as to fu n c tio n .

Roughly h a l f a r e d ia g n o s tic s e r v ic e s , w h ile th e rem ainder

b e s id e s c o n s u ltin g on c a s e s f o r th e c o u rt u n d e rta k e o u t - p a t ie n t treatm ent

218 in an e f f o r t t o b r i n g a b o u t t h e e s s e n t i a l changes to e n a b le t h e c h i l d to make more s a t i s f a c t o r y a d ju s tm e n t in our highly complex c i v i l i z a t i o n . A ctually, to e f f e c t th e m o st l a s t i n g headway a g a in st th e g ra v e p ro b le m s of delinquency and p e r s o n a l i t y d i s o r d e r , thoroughgoing c u l t u r a l c h a n g e s to reduce in d iv id u a l and s o c i a l s o u rc e s o f f r u s t r a t i o n u l t i m a t e l y i n v o l v ­ ing the whole w o rld a r e u n d o u b te d ly n e ce ssa ry .

Sweeping ch an g es i n t h e

c u ltu ra l p a tte rn t o e l i m i n a t e some o f th e underlying c a u s a t iv e f a c t o r s in mental d ise a s e an d c rim e a r e n o t imminent, however.

Even i f t h e y w ere

to occur and re a s o n a b ly o p tim a l environm ental c o n d itio n s o b ta i n e d , s t i l l c e rta in highly i n d i v i d u a l f a c t o r s — h e re d ita ry m ental s lo w n e s s , c o n s t i ­ tu tio n a l p r e d i s p o s i ti o n , b i r t h i n j u r i e s , p hysical h a n d ic a p s , s e q u e l l a e o f in fa c tio u s d is e a s e s , t o name o n ly a few — may be e x p e c te d t o p e r s i s t a s causal in flu e n c e s .

As a r e s u l t , s e r v ic e s designed to a m e lio r a te i n d i v i d u a l

adjustm ent problem s w i l l c o n tin u e t o be necessary.

F or t h a t r e a s o n , a t t e n ­

tio n need be p a id t o c o n d it i o n s i n th e c o u rt c lin ic s w hich h e lp t h e m o d em ju v en ile c o u rt t o r e h a b i l i t a t e t h e young d elin q u en t. J2&JuYenUe

Psychiatric Clinics

In s e t t i n g down o b s e r v a tio n s and suggestions on j u v e n i l e c o u r t c lin ic s , the i n v e s t i g a t o r w ish e s to s tr e s s th e f a c t t h a t th e y a r e b y n o means conceived o f a s a p a n a c e a .

The c lin ic i s n o t th e u l t i m a t e fo r m u la

f o r mental h e a lth and t h e e li m in a ti o n o f delinquency:

an y su ch i d e a w o u ld

r e f l e c t a f a i l u r e t o u n d e rs ta n d t h e m u ltip le d e te rm in a tio n o f t h e c o n d i­ tio n s th e in tim a te ly in te rw o v e n c o n s t it u t io n a l , e m o tio n a l, i n t e l l e c t u a l , so c ia l and economic f o r c e s i n v a r i a b l y involved.

The c l i n i c , h o w e v e r, p r o p e r ­

ly used, can se rv e im p o r ta n tly when i t i s geared to a p r e v e n t iv e a p p ro a c h and a q u a l i t a t i v e , i n d i v i d u a l i z e d s e r v ic e .

219 S ta rtin g E arly A c tu a lly , w ith a r e a l l y e f f e c t i v e netw ork o f community child g uidance f a c i l i t i e s p r o v id in g tre a tm e n t s e r v ic e s , th e need f o r court c l i n i c s w ould b e s u b s t a n t i a l l y red u ced .

The i n v e s ti g a t o r can hardly stre ss

s u f f i c i e n t l y t h e im p o rta n c e o f p ro v id in g c l i n i c a l s e r v ic e s to children b e fo re t h e i r p ro b lem s m a n if e s t them selves a s l e g a l d elin q u en c y .

Children

w ith sc h o o l d i f f i c u l t i e s d e se rv e t o b e i d e n t i f i e d and r e f e r r e d long before m a lad ju stm en t i n c l a s s e s p ro d u ces a w e ll- e s ta b lis h e d p a tt e r n o f truancy. P a re n ts m ust b e s e n s i t i z e d t o re c o g n iz e and must have a c c e s s to f a c ilitie s which can f u r n i s h h e lp w ith h a b it o r b e h a v io r d is o r d e r s ig n s and neurotic sym ptom atology p r e s e n t i n t h e i r c h ild r e n . U n lik e t h e c h i l d guidance s e r v ic e s , th e c o u rt c l i n i c is obliged t o o p e ra te tin d e r c e r t a i n c o n d itio n s which a re a h a n d ic ap .

Some of th is

d i f f i c u l t y ste m s from th e f a c t t h a t th e s e t t i n g i s a u th o r ita r ia n .

While

much o f th e work o f th e c l i n i c l i e s in su p p ly in g o p p o r tu n itie s fo r sa tis­ f y in g r e l a t i o n s w ith p e rm is s iv e a d u lt th e r a p is t- g u id e s i n s itu a tio n s w hich a llo w f o r c o n s id e r a b le p ro p h y la c tic e x p re ssio n o f resentm ent, h o stil­ i t y , d e s t r u c t i v e n e s s , a s w e ll a s o th e r p e n t-u p n e e d s, th e agency operates w ith in th e fram ew ork o f an i n s t i t u t i o n o f law enforcem ent s t i l l not free from th e t a i n t o f p u n itiv e n e s s and r e t a l i a t i o n .

F u r th e r , a s therapy is

m ost f r u i t f u l w ith in d iv i d u a ls who f e e l t h e i r own te n s io n s and need fo r tr e a tm e n t t o t h e e x t e n t t h a t th e y come v o lu n ta r ily (even making sacrifices in th e p r o c e s s ) , i n p a r t b e ca u se o f th e r e s t r i c t e d so u rce o f re fe rra ls , b e c a u se some o f t h e c a s e s may b e more o r l e s s u n d er p re s s u re to go to the c l i n i c ( a c t u a l l y a s o r f e l t to be a c o n d itio n o f p ro b a tio n o r an alterna­ t i v e t o com m itm ent), and b e c a u se c h ild re n w ith l e s s se v ere problems may n o t be d e te c t e d en d th e more o b v io u sly d is tu r b e d c h ild re n a re selected

220 f o r r e f e r r a l , t h e t a s k o f th e c o u rt c lin ic i s g r e a tly c o m p lic a te d and th e lik elih o o d o f a c h ie v in g lo n g -te rm th erap eu tic su c c e sse s i s d im in is h e d . Scope

One o f t h e p o i n t s t h a t emerged q u ite c le a r l y from t h e r e s e a r c h i s th a t the c o u rt c l i n i c s s e t f o r themselves a r a th e r n arro w s c o p e .

They a c ­

cep t, as a p re m is e , th e p r e v a i li n g dichotomy of d ia g n o s is o r t r e a t m e n t , an d conceive o f t h e i r f u n c tio n e i t h e r in the lim ite d term s o f s e r v in g a s a con­ su ltin g arm f o r t h e c o u r t , o r a s a treatm ent c e n te r, o r , i n some i n s t a n c e s , as both.

C le a r ly , th e g e n e r a l conception of the c o n tr i b u ti o n o f t h e a g en c y

need be b ro ad en ed .

I t s h o u ld b e made more p re v e n tiv e i n e m p h a s is .

From

the long-term p o i n t o f v iew , i t s personnel may be a c c o m p lish in g much m ore by le c tu rin g t o a group o f te a c h e r s , p a re n ts, o r p o l i c e , o r by c o n s u l ti n g with community a g e n c ie s on j o i n t problems than by k e e p in g w ith in t h e con­ fin e s of p e rfo rm in g p h y s ic a l exam inations, stu d ie s o f m e n ta l s t a t u s , p r e ­ paring case h i s t o r i e s o r co nducting th erap eu tic s e s s io n s i n t h e c l i n i c . The same i s t r u e when th e c l i n i c serves as a t r a i n in g c e n t e r f o r c l i n i c a l personnel and o t h e r i n t e r e s t e d p ro fe ssio n a ls, and a s a r e s e a r c h c e n t e r . Of c o u r s e , t o do t h i s , to broaden the w hole h o riz o n o f t h e c l i n i c , f a r more p e rs o n n e l a r e n e e d e d ,

lloreover, to do a n y th in g re s e m b lin g a th o ro u g h

job with j u s t t h e p r e s e n t number of cases who come b e f o r e th e j u v e n i l e c o u r t (not to m ention p r e - d e l in q u e n ts or the probable in c r e a s e o f d e lin q u e n c y cases a t t r i b u t a b l e to th e p e r s i s t e n t r is e in p o p u la tio n ) , a v a s t i n c r e a s e in personnel I s e s s e n t i a l .

I n the process, e x is tin g c l i n i c s s h o u ld b e

brought up to a t l e a s t t h e r a t i o o f personnel recommended by t h e N a t io n a l

221 Com m ittee f o r M en tal h y g ie n e .

P a id in te x n e s h lp s should be provided a t

re a s o n a b ly a d e q u a te s a l a r y l e v e l s .

I n a d d itio n , such a ssista n c e as commun­

i t y g ro u p s l i k e t h e J u n io r L eague, B ig B ro th e rs o r American Women's Volun­ t a r y S e r v ic e s m ig h t w ant t o p ro v id e should be f u l l y in te g ra te d . S uggested Improvements The p r o v i s i o n o f a d d it i o n a l p e rs o n n e l sh o u ld make possible cer­ t a i n im provem ents i n th e s e r v ic e now ren d e red by c o u rt c lin ic s . E x te n s io n o f S e r v ic e s The u n o f f i c i a l l y d e lin q u e n t o r p r e - d e lin q u e n t, with whom some o f th e m ost e f f e c t i v e work o f a p re v e n tiv e n a tu r e can be done, currently n e g le c te d p a r t l y b e c a u se th e y a r e l a s s o b tru s iv e and because school and c o u r t f a c i l i t i e s a r e busy w ith c a se s o f more advanced delinquency or more s e v e re p e r s o n a l i t y p ro b lem s, w i l l r e c e iv e c l i n i c a l a tte n tio n .

This exten­

s io n o f s e r v i c e s t o re a c h th e more t r e a t a b l e p re -d e lin q u e n t group, and c lo s e c o l l a b o r a t i o n w ith community a g e n c ie s o r th o s e s e t up by the court ( l i k e t h e B u re a u o f A djustm ent) t o h a n d le c a se s l e s s form ally is an import­ a n t s te p . The p e r i o d o f w a itin g b e fo r e th e c l i n i c a l appointment may be s u b s t a n t i a l l y re d u c e d .

Cases o f an u r g e n t n a tu r e w i l l be assured of re­

c e iv in g pro m p t h e lp on an emergency b a s i s .

*

A d d itio n a l s p e c i a l i s t s such a s th e p e d i a t r i c i a n , n e u ro lo g ist, research s o c i o l o g i s t , v o c a tio n a l c o u n se lo r, speech t h e r a p i s t and remedial t e a c h e r m ig h t v e ry p r o f i t a b l y b e added t o th e s t a f f of larg er centers. Though s p e c i a l i z a t i o n i s n o t e n t i r e l y w ith o u t drawbacks, economies p a r t i c u l a r l y i n tim e m ight r e s u l t , f o r in s ta n c e , from having medical e x a m in a tio n s done by g e n e ra l p r a c t i t i o n e r s r a t h e r than by p sy ch iatrists (who m ig h t, d u r in g th e p h y s ic a l e x am in a tio n , b e jeopardizing the r e l a t i o n s h i p n eed ed f o r p s y c h ia tr ic c o n ta c t s ) .

222 More p e r s o n n e l w i l l enable a higher p r o p o r tio n o f a d j u d i c a t e d cases to b e se e n b y c l i n i c a l team members* S i m i l a r l y , y o u n g s te rs may receive r e g u l a r t r e a tm e n t I n a c c o rd ­ ance with t h e i r n e e d s r a t h e r than b r i e f , d ia g n o s tic c o n ta c t s o n l y . S e rv ic e t o n e g le c te d c h ild ren , the m e n ta lly d e f i c i e n t , an d o t h e r y o ungsters r e f e r r e d t o t h e ju v e n ile court may a l s o b e ex p an d ed . A d u lts in v o lv e d in the court a c tio n may b e s tu d ie d a n d t r e a t e d . A co n cu rren t p s y c h o th e r a p e u tic a tta c k on th e e m o tio n a l p ro b le m s o f t h e p a r ­ en ts along w ith tr e a tm e n t f o r the c h ild may become a p a r t o f s t a n d a r d p r o ­ cedure I n s te a d o f som eth in g done only on an e x p e rim e n ta l b a s i s o r i n f r e ­ quently , a s a t p r e s e n t . S c ie n tific S e l e c ti o n A d d itio n s t o t h e c l i n i c a l s ta f f s do n o t mean t h a t e v e r y young­ s t e r w ill r o u t i n e l y b e examined by three o r fo u r c l i n i c a l s p e c i a l i s t s an d th a t he and h i s p a r e n t s w i l l , in a tw inkling, f i n d th e m s e lv e s on p sy ch o ­ a n a ly tic co u ch es s e v e r a l h o u rs weekly fo r an e x te n d e d p e r i o d .

O n ly th e

most p a r tis a n m ig h t a rg u e t h a t every child who comes b e f o r e t h e j u v e n i l e c o u rt, ip s o f a c t o , n e e d s c l i n i c a l a ssista n c e ; t h i s i s n o t c o n firm e d b y e x p erience.

To b e g in w i t h , a s outgrowths of c u l t u r a l l a g i n o u r s t r u c t u r e

o f laws and e n fo rc e m e n t, some of the cases now h a n d le d b y t h e c o u r t m ig h t w ell be se rv e d by community agencies operating e n t i r e l y i n f o r m a ll y an d o u tsid e t h e j u d i c i a l p a l e .

Of those cases p ro p e rly th e s u b j e c t o f ju v e n ­

i l e co u rt p u rv ie w , a g a in n o t every c h ild r e p re s e n ts a c l i n i c a l p ro b le m . Hence p ro p e r s e l e c t i o n o f case s f o r the c lin ic i s a v e ry b i g t a s k . W hile i t i s u n l ik e l y , in the near f u t u r e , t h a t c l i n i c a l s e r v i c e s w ill be expanded t o t h e p o i n t th a t each in d iv id u a l b e f o r e t h e j u v e n i l e co u rt w i l l r e c e iv e t h e c l i n i c a l service needed, a s c i e n t i f i c s c r e e n in g

223 p r o c e d u r e p e rh a p s p a r a l l e l t o th e p la n d e sig n e d f o r New York can be e s t a b l i s h e d w hich w i l l re a so n a b ly a s s u r e t h a t th o s e cases requiring a t ­ t e n t i o n w i l l be s e rv e d .

The " lu c k f a c t o r " i n c l i n i c a l re fe rra l must be

*

e lim in a te d .

S i m i la r ly , th e fu n d a m e n ta lly e m o tio n a lly healthy child

whose d e lin q u e n c y may b e l a r g e ly c ir c u m s ta n tia l o r a c tu a lly a m atter of n a r r o w l y - i n t e r p r e t e d law s w i l l be sp a re d th e r e f e r r a l and the c lin ic 'a f a c i l i t i e s w i l l b e a v a i la b l e f o r more s u i t a b l e cases* C lo s e r C o lla b o r a tio n A n o th er outg ro w th o f expanded c l i n i c s w i l l r e f l e c t i t s e l f in a num ber o f w ays.

The approach t o e a s e s w i l l be r e a l l y th a t of the smoothly

w o rk in g team i n p r a c t i c e r a t h e r th a n j u s t i n th eo ry * and p la n n i n g w i l l r e s u l t from a c t u a l co n fe ren c es*

Case evaluations

N a tu ra lly , th is process

i s much m ore tim e-co n su m in g , b u t th e exchange o f id e a s between team members w ith d i f f e r e n t backgrounds w i l l p ro d u ce b e t t e r r e s u l ts *

Further, much

c l o s e r c o l l a b o r a t i o n w ith o th e r members o f th e c o u r t 's s ta f f w ill be fa c ilita te d * e n ce s*

There i s l i t t l e t h a t i s sa c re d a b o u t c li n i c a l case confer­

Ju d g e s and p ro b a tio n o f f i c e r s — th e p e o p le who have to decide

an h e l p i n t h e c a r r y in g o u t o f th e tr e a tm e n t p la n devised by the c lin ic can b e made more f a m i l i a r w ith w hat i s u n d e rly in g c l i n i c a l thinking.

The

p r o c e s s s h o u ld b e made l e s s m y s te rio u s , more m eaningful and re a l to other w o rk e rs i n t h e c o u r t d e s p ite th e added burden o f t h i s educational work. T hrough t h e i r p a r t i c i p a t i o n , o th e r c o u r t p e rs o n n e l may respond more r e a d i l y t o t h e re a s o n in g o f th e c l i n i c a l s t a f f , and through sharing in

*

I n c i t i e s w ith c l i n i c a l f a c i l i t i e s c h ild r e n who a re "lucky enough" to b e a s s ig n e d t o p s y c h o lo g ic a lly -a w a re p ro b a tio n o ffic e rs and to sen­ s i t i v e ju d g e s w ith an a p p r e c ia tio n o f th e c l i n i c a l approach may be r e f e r r e d to th e c li n i c .

m th e p ro c e s s o f e v o lv in g th e treatm ent plan a r e l i k e l y t o b e m ore i n c l i n e d to see t h a t i t i s f u l l y c a rrie d out.

They, to o , w i l l th e n h a v e a s m a ll

stak e i n t h e p la n w hich w ill have g re a te r chance o f m a t e r i a l i z i n g . P u b lic E o la tio n s The e x te n s io n o f c lin ic a l case c o n fe re n c e s and s e m in a rs n e e d n o t sto p w ith c o u r t p e rs o n n e l but can p ro fita b ly re a c h s o c i a l w e l f a r e w o rk e rs and i n t e r e s t e d members o f the community as w e l l.

T h is d o e s n 't mean t h a t

c l i n i c a l c o n fe re n c e s w i l l be c lu ttere d up w ith d i l l e t a n t e s , b u t r a t h e r t h a t r e s p o n s ib le community groups and civic o r g a n iz a tio n s w i l l f i n d t h a t th e y have an in v e s tm e n t i n th e c lin ic and th a t c l i n i c b u s in e s s a n d p r o g r e s s i s to an e x te n t t h e i r concern.

Through p a r t i c i p a t i o n i n c o n f e r e n c e s an d sem i­

n a r s , th e y can be made aware of the ta n g ib le n e ed s c o n f r o n tin g th e c h i l d r e n seen i n th e c o u r t and th e c lin ic .

Ib is p a r t i c i p a t i o n by w e l f a r e w o rk e rs

and c iv ic groups may b e an important step i n b r in g in g a b o u t m ore a d e q u a te re s o u rc e s f o r th e community of the follow ing s p e c i a l ty p e s : m e n ta l h y g ie n e f a c i l i t i e s f o r c h ild r e n and ad u lts who are n o t in v o lv e d w ith t h e c o u r ts ? bed space i n w e ll-e q u ip p e d , progressive p s y c h i a t r ic h o s p i t a l s ( e s p e c i a l l y f o r b o r d e r l i n e c a s e s who may hold considerable l a t e n t d a n g e r f o r t h e com­ munity and f o r th em selv es but who are n o t so o v e r t l y d i s t u r b e d t h a t th e y can b e l e g a l l y com m itted); fo s te r homes to m eet n o t o n ly t h e demand i n num bers, b u t q u a l i t a t i v e l y suited to th e p h y s ic a l and e m o tio n a l r e q u i r e ­ ments o f t h e c h ild r e n a s w ell; child-care i n s t i t u t i o n s o p e r a t i n g dem ocra­ t i c a l l y i n a l l r e s p e c t s , (sm all, n o n -s e c ta ria n , i n t e r r a c i a l u n i t s , d e ­ sig n ed t o m eet in d iv id u a l needs as closely a s p o s s ib l e i n a f a m i l y - c o t t a g e s e t t i n g ) ; and re s e a r c h f a c i l i t i e s to help make th e t o t a l a t t a c k on t h e d e lin q u e n c y and m en tal disease problem s c i e n t i f i c a l l y s o u n d e r, f a r t h e r re a c h in g and more e f f e c t i v e .

225 By b r in g in g community r e p r e s e n t a t i v e s i n to the c lin ic and by having c l i n i c p e rs o n n e l go i n t o th e community th ro u g h le c tu r e s , the radio, the press an d o t h e r m edia o f in f o r m a tio n , th e c i t i z e n r y may be helped to face th e ir own r e s p o n s i b i l i t i e s more d i r e c t l y .

They w i l l be a b le to recognise th a t the clin ­

i c i s n o t th e "dumping ground" f o r c h ild r e n f o r whom f a c i li t ie s have not been p ro v id e d .

Cases w hich have p o o r tr e a tm e n t p ro s p e c ts and need important en­

v ir o n m e n ta l changes c an n o t sim ply b e p a sse d o f f to the clinic fo r lack of o t h e r r e s o u r c e s t o h e lp them . T ra in in g An atm osphere o f c lo s e r c o ll a b o r a t io n , i n general, w ill lead to m ore i n t i m a t e work w ith and f u l l e r u t i l i z a t i o n o f lo c a l colleges than now p re v a ils .

The c l i n i c s have much t o g a in b y b e in g more active in tra in in g .

F i r s t , a l e r t n e s s and c o n tin u e d p r e p a r a tio n i s v i r tu a ll y forced upon personnel e n t r u s t e d w ith t r a i n i n g r e s p o n s i b i l i t i e s .

C lin ic procedures, constantly open

t o i n s p e c t i o n and c r i t i c i s m , have t o keep p a ce w ith la te s t developments* T h en , a f t e r an i n i t i a l in v e stm e n t o f tim e , c l i n i c a l services can be extended t o a l a r g e r gro u p .

F i n a l l y , & c o n s ta n t supply o f new personnel and continued

a c t i v i t y in re se a rc h a re p r a c tic a lly a ssu re d .

Research R esearch i s a n o th e r so u rc e o f d i f f i c u l t y : although subscribed to i n t h e o r y , i t i s much th e custom t o s a c r i f i c e re se a rc h to the pressure of t h e c a s e lo a d .

W hile h a rd t o e v a lu a te w hich i s u ltim a te ly more co stly , i t

may w e l l p ro v e t o be th e n e g le c t o f r e s e a r c h . m u st b e a c c o rd e d i t s r i g h t f u l p l a c e .

S c ie n tific investigation

W hile c a s e s may not be "finished"

i n t h e p r o c e s s , r e s e a r c h tim e i s n o t w a ste d , b u t i s spent in validating w o rk in g h y p o th e s e s , in c r e a s in g s k i l l s and d e v elo p in g improved methods which a c c r u e t o th e b e n e f i t o f th e p a t i e n t s and th e community.

*

* The s ig n o f a g r e a t e r r e c o g n itio n o f th e im portance of research in Hew Tork, a s a r e f l e c t i o n o f developm ents i n c u r r e n t c lin ic a l p ractice is encourag­ in g

226

The combined humanistic and s c i e n t i f i c t r a d i t i o n s p l u s t h e s p e c i a l r e s e a r c h t r a i n i n g o f th e psychologists and s o c i o l o g i s t s e q u ip them p a r t i c u ­ l a r l y f o r a v i t a l ro le in th is c lin ic a c t i v i t y .

F u lle r u s e o f th e s e a s s e t s ,

encouragem ent o f c lo s e r collaboration o f th e c i s c i p l i n e s , and em ploym ent o f b o th ty p e s o f s p e c ia lis ts in la rg e r numbers w i l l do much t o e n h an c e t h e q u a li t y o f th e re s e a rc h and ultim ately im prove th e c l i n i c a l s e r v i c e s . Follow-Ups B oth a s & p a rt of the research a c t i v i t y and a s w e ll a s i n t h e i n t e r e s t o f f u l l e r se rv ic e to the p a ti e n t , a much more a d e q u a te fo llo w - u p and a f t e r - c a r e program i s necessary.

What e x i s t s a t p r e s e n t i s a v i r t u a l

v o id : g r e a t e x te n sio n of these services i s r e a l l y e s s e n t i a l .

E s p e c ia lly

i n view o f th e r e l a t i v e d iffic u lty in h e re n t i n some o f th e p r e s e n t c o u r t c l i n i c c a s e s , fo llo w -u p contacts should b e p ro v id e d i f o n ly a s i n s u r a n c e on th e tim e a lre a d y invested in trea tm e n t.

*

U n r e s tr ic te d S e rv ic e s F i n a l l y , even more so than o th e r g ro u p s, m i n o r i t i e s u n d e r s o c i a l and econom ic p re s s u re s of discrim ination and e x p e r ie n c in g t e n s i o n s f o s t e r e d by a d v e rse l i v i n g and working conditions f r e q u e n tly n e e d such h e lp a s t h e modem c l i n i c can a ff o r d .

In the i n t e r e s t o f p r o t e c t i o n f o r t h e w hole

community, sh o rtsig h te d n e ss must not be a llo w e d t o i n t e r f e r e w ith t h e p r o v is io n o f c l i n i c a l services on the b a s is o f n eed an d i n a c c o rd a n c e w ith such o t h e r accepted p rin cip les o f c l i n i c a l p ro c e d u re a s t h e l i k e l i ­ hood o f resp o n d in g t o help, the a v a i l a b i l i t y o f b e t t e r r e s o u r c e s , a n d p e r ­ haps th e v a lu e to a research program.

*

At tim e s , th e em otional balance of th e p a t i e n t i s to o p r e c a r i o u s , a n d h e can g a in s e c u r ity from the knowledge t h a t u n d e r th e p r e s s u r e o f a d v e r s e c o n d itio n s i n th e future he can s t i l l t u r n t o t h e c l i n i c f o r some ( a l b e i t b r i e f ) continuation of th e h e lp p r e v io u s ly a f f o r d e d .

227 On th e T reatm en t Program The m ost obvious f a c t a b o u t program s o f treatm ent i s th a t they m u st be made more b ro a d ly a v a ila b le *

The l im ita tio n of treatm ent to some

f o u r t o seven h u n d red y o u n g s te rs a y e a r i s p i t i f u l l y f a r from even the m o st c o n s e rv a tiv e e s tim a te s o f needs*

As p a r t of i t s a v a ila b ility , the

d e la y a tt e n d a n t on th e b e g in n in g o f th e p ro c e s s should be reduced.

Closed

i n t a k e s o r t h r e e t o six -m o n th w a itin g p e rio d s may reliev e adm inistrative p ro b le m s , b u t th e y do n o t a v a i l i n s o lv in g th e maze of troubled in terp er­ s o n a l r e l a t i o n s h i p s i n w hich th e young d e lin q u e n ts daily find themselves* F o c u sin g on F a m ilie s The w orking u n i t o f th e c l i n i c s h o u ld be the family wherever i n d i c a t e d b e c a u se th e u n d e rly in g p a th o lo g y so o ften has firm roots in the c h i l d 's r e l a t i o n s w ith th e p a re n ts *

W ith th e success of treatm ent often

c o n tin g e n t on some m o d if ic a tio n i n th e l i f e s itu a tio n of the children, t r e a t i n g c h ild r e n a lo n e o f t e n s e l l s them s h o r t f o r lack of attempted m iti­ g a t i o n o f th e atm osphere i n w hich th e y l i v e . The p a r e n ts o f d e lin q u e n t c h ild r e n a r e so often those of finan­ c i a l l y m a rg in a l f a m i li e s who e i t h e r m ust work o r have other children to t a k e c a r e o f , and i n a d d itio n may r e s e n t c o u r t in tru sio n and the whole p r o c e s s o f b e in g " t r e a t e d . "

As a r e s u l t , w ith o u t compulsion, they must

b e encouraged t o ta k e a d v a n ta g e o f tr e a tm e n t se rv ic e s.

To meet the

p r a c t i c a l l i f e n e e d s o f th e p a r e n ts e s p e c i a l l y , as well as those of some o f th e y o u n g s te r s , th e n i n e - t o - f i v e , M onday-to-Friday working schedule o f th e c l i n i c c a l l s f o r r e v i s i o n .

A fte rn o o n , evening, and weekend c lin ic s

w ould s p a re sc h o o l c h ild r e n th e n e c e s s ity o f tak in g time o ff from classes, t h e em barrassm ent o f h a v in g t o a c c o u n t f o r t h i s time to teachers and c la s s m a te s , and m oreover would p e rm it g r e a t e r contact with working parents

228

w ithout p e n a liz in g them through lose o f so r ely -n eed ed w ages.

N a t u r a lly ,

the personn el o f these c lin ic s should n ot be com pelled t o tak e on added burdens w ithout adjustments of time and s a la r y .

Alas .of Treatment The aims of treatment and the e x te n t to which i t i s c a r r ie d should be determined by professional c o n sid e r a tio n s based on th e c h ild * s t o t a l l i f e s itu a tio n rather than on a d m in istr a tiv e e x p ed ien cy .

With

fu r th e r development and refinement o f th e ra p eu tic p ro ced u res, i t sh ou ld be p o s sib le to extend the working aims o f th e r e h a b ilit a t io n p r o c e s s b e­ yond th e rath er lim ited goals currently s e t in th o se c o u r t c l i n i c s which provide treatm en t.

In any event, arb itrary g e n e ra l tim e l i m i t s on th e

duration o f treatm ent impede most e f f e c t iv e s e r v ic e , and th e tim e a llo w e d weekly fo r in d iv id u a l sessions should be more c l o s e l y r e la t e d t o th e n eed s o f the p a tie n t than the present fam iliar p a tte rn o f one hour p er week a llo w s.

True, providing more in ten sive s e r v ic e means t h a t each t h e r a p is t

t r e a t s fewer p a tie n ts; however, the s o lu tio n l i e s n o t in c u r t a i l in g therapy but r a th er in making i t more a v a ila b le by t r a in in g a d d it io n a l q u a lifie d p ersonn el. Methods Concerning approaches to the treatm ent p r o c e s s , th e la c k o f an u ltim a te p e r fe cte d treatment method le a v e s room f o r wide l a t i t u d e , f l e x ­ i b i l i t y , e c le c tic ism and experimentation.

While th e d e e p -ro o te d o r ig in s

o f th e problems and the frequently n eg a tiv e l i f e - s i t u a t i o n s o f th e c h ild ­ ren in th e cou rt c lin ic s make a longer term o f more in t e n s iv e in d iv id u a l treatm ent o fte n & virtual n ecessity, there i s no golden roads through r e ­ search sim pler y e t more effectiv e methods may e v e n tu a te .

Over th e n ear

229

te r m , i t w ould seem t h a t more m ig h t p r o f i t a b l y be done with narcoanalysis a n d h y p n o a n a ly s is th a n a t p r e s e n t .

M ethods involving group situ a tio n s as

i n g ro u p p s y c h o th e ra p y , a c t i v i t y group th era p y o r possibly Sociodrama p ro m is e much f o r th o s e who w i l l e x p lo r e and ex p lo it them.

As fo r the

s p e c i f i c te c h n iq u e s u s e d i n th e tr e a tm e n t p ro cess, ingenuity and adapt­ a b i l i t y r a t h e r th a n d o g m atic d e v o tio n t o a p a tte rn should hold the key to p ro g re ss.

And, i n c i d e n t a l l y , s in c e i n treatm ent people's experiences

a n d p ro b le m s a r e b e in g p ro b e d , t h e i r l i v e s m odified, (and in narcoanalysis a n d e n d o c r in e t h e r a p i e s , ch em ic al p r o c e s s e s are a lte re d ) , c ertain safe­ g u a rd s a r e n e c e ssa x y s th e s e may b e m et by p lacin g re sp o n sib ility in the h a n d s o f a l e r t s u p e r v is o r s and a d m i n i s t r a t o r s . P e rso n n el As a c o n se q u e n c e , a n im p o r ta n t question a ris e s as to who s h a ll do t h e w ork o f tr e a tm e n t.

To do j u s t i c e t o the tremendous need fo r

c l i n i c p ro g ram s t h a t do more th a n l a b e l , t h a t a id in personality recon­ s t r u c t i o n , a l a r g e s u p p ly o f a d d i t i o n a l th e ra p is ts i s needed.

Delving

i n t o s o u r c e s o f r e c r u i t s f o r t h i s w ork, i t i s obvious th a t no single p r o f e s s i o n o r d i s c i p l i n e h a s a c o rn e r on th e market of people with a cap­ a c i t y f o r a c c e p tin g o t h e r s , f o r g iv in g o f them selves, and fo r arousing a tt a c h m e n t s t h a t can f u r n i s h th e b a s i s f o r producing changes in human v a l u e s a n d b e h a v io r .

S p e c ia liz e d t r a i n i n g and experience are of g reat

im p o r ta n c e i n augm enting th e pow ers o f a th e r a p is t, but the s ta rtin g p o i n t i s t h e p e rs o n . T hus, c e r t a i n c r i t e r i a f o r e n tr u s tin g therapeutic resp o n sib il­ i t i e s may b e p o s t u l a t e d .

Em phasis m ig h t w e ll be placed on the in d iv id u a l's

m a t u r i t y , s t a b i l i t y , i n t e l l i g e n c e and l i f e adjustm ent. i n t e r e s t i n tr e a tm e n t work a r e im p o r ta n t.

S e n sitiv ity and

Further, having experienced

230 th e th e ra p e u tic process personally does much t o e q u ip th e w o rk e r t o h e lp o th ers*

Beyond th is , intensive t r a i n in g i n th e s o c i a l a s w e ll a s t h e

p h y s ic a l sc ie n c e s , sp ecializatio n i n d e a lin g w ith th e p ro b lem s o f t h e e m o tio n ally disturbed, and extensive c l i n i c a l e x p e rie n c e u n d e r a d e q u a te s u p e rv isio n a re necessary.

While th e s e q u a l i f i c a t i o n s a r e im p o sin g an d

r e s t r i c t i v e , they re fe r to the h ig h e r l e v e l s o f p r o f e s s i o n a l d e v e lo p m e n t. O ther p eo p le w ith sone of the b a sic p e r s o n a l i ty r e q u i s i t e s , t h e I n t e r e s t , y e t w ith o u t f u l l train in g nay be e n tr u s te d w ith t h e r a p e u t i c r e s p o n s i b i l i t i e s p e rh a p s more lim ited and under p ro p e r s u p e rv is io n a s p a r t o f t h e i r own tr a in in g * On th e P sychologiat In the Ju v en ile C ourt C lin ic Looking b rie fly a t the work done by th e c l i n i c a l p s y c h o l o g i s t i n e x is ti n g ju v e n ile court c lin ic s , i t i s c le a r t h a t c e r t a i n im p ed im en ts p re v e n t him from being of g re a te s t h e lp to th e d e lin q u e n t c h i l d r e n r e f e r r e d . C taE finlflhatacIeg Y e m s Ifa x ln a * F u n c t io n in g

Foremost among the b a r te r s to most v a lu a b le f u n c t i o n in g a r e t h e undue em phasis placed on h is se rv ic e i n an e s s e n t i a l l y p sy c h o m e tric r o l e and th e v e ry heavy work schedules.

C a st i n a r o l e by now t r a d i t i o n a l , h e

h a s n o t y e t been fu lly welcomed a6 a c o n tr i b u to r o f more th a n m e n ta l t e s t d ata*

When he i s not busy measuring i n t e l l i g e n c e q u o t i e n t s , he i s p e r ­

hap s t e s t i n g f o r subject d i s a b i l i t i e s o r w r itin g up h i s f i n d i n g s .

E ven

i n th e r o l e o f a te s te r , he could do much more i f h i s t r a i n i n g w ere f u l l y u tiliz e d .

There could be g reater p ro b in g o f th e dynam ics u n d e r ly in g t h e

c o n d itio n s o f the p a tien t which m ight be e x p lo re d e f f e c t i v e l y b y t h e u s e o f p la y m a te ria ls as well as by more s ta n d a rd iz e d p r o j e c t i v e t e s t s . P ro p e rly u s e d , h is to o ls yield v a lu a b le d u e s t o u n d e rly in g p ro b le m s ,

231

c o n f l i c t s and te n s io n s o u r c e s , t o f r u i t f u l therap eu tic le a d s, to prognosis a s w e ll a s t o t h e p a tie n t* s p r o g r e s s and responsiveness to treatm ent. In th e " o n e -s h o t" stu d y o f th e p a tie n t th a t seems to p re v a il, m o reo v er, t h e r e i s subm erged o r l o s t , to q u ite an e x te n t, the psychologist a s a p e rm is s iv e human b e in g w ith a p o t e n t i a l fo r e stab lish in g a re-educa­ t i v e r e l a t i o n s h i p w ith th e p a t i e n t .

Busy w ith the a c q u isitio n o f, a t

tim e s , e m b a rra s s in g f a c t s m o stly a b o u t in te lle c tu a l a sse ts and l i a b i l i t i e s , t h e im p o rta n t c a t a l y s t i n t h e p r o c e s s o f re h a b ilita tio n , the sa tis fy in g r e l a t i o n s h i p w ith an a d u l t , may b e s a c r if ic e d . T here i s th u s b r o u g h t t o th e fo re fro n t the need fo r a s h i f t to a tr e a tm e n t o r i e n t a t i o n .

W hile t h e r e i s a co ntinuity in the diagnostic

and tr e a tm e n t p r o c e s s e s , th e p s y c h o lo g is t cannot become l o s t in mere l a b e l i n g : he m ust s t r i v e f o r a thorough-going preventive and treatm ent o u tlo o k i n t h e c l i n i c .

O p e ra tin g i n accordance with such a p o in t o f view,

e s p e c i a l l y u n d e r th e enorm ous p r e s s u r e s of needs or tan g ib le se rv ic e s, th e r e a s o n a b ly eq u ip p e d p s y c h o lo g is t would assume h is f a i r share of th e ra p e u tic r e s p o n s i b i li t ie s .

F o llo w in g the example of th e Judge Baker

G uidance C e n te r and o t h e r l e a d in g guidance u n i ts , th is work would be c a r r i e d on u n d e r th e s u p e r v is io n o f th o s e b e tte r train ed and thoroughly e x p e rie n c e d i n h a n d lin g su ch tr e a tm e n t problems as may occur in the agency.

The s u p e r v is io n w ould n o t b e nominal bu t recognized as an in ­

h e r e n t p a r t o f th e p ro g ram .

F u r t h e r , t o meet both the problem of heavy

lo a d s and th e s p e c i a l e m o tio n a l problem s of some types of cases, more u s e o f group in te r v ie w and group th e r a p e u tic methods would be made. I n r e l a t e d a c t i v i t i e s , th e psychologist would play a much g r e a t e r p a r t i n th e p r o c e s s o f v o c a tio n a l counseling which can do so much t o h e lp th e b e le a g u e re d a d o le s c e n t to make a sa tis fa c to ry t o ta l

232 a d ju stm e n t.

Those psychologists w ith s p e c i a l t r a i n i n g n i g h t b e u t i l i z e d

f a r more fu lly for the guidance o f th e e x c e p tio n a l c h i l d — t h e h a n d i­ capped, th e superior, fo r help w ith a p p a r e n tly n o n -o rg a n ic sp e e c h d i f f i ­ c u l t i e s , and as collaborators in program s o f re m e d ia l t r a i n i n g f o r c h i l d ­ re n who hare d iffic u lty in m asterin g t h e i r sc h o o l s u b je c ts * The research background t h a t goes i n t o t h e m aking o f t h e f u l l y t r a i n e d c lin ic a l psychologist i s b e in g l a r g e l y w a s te d .

H is a b i l i t y t o

f u l f i l l a train in g function — w hether o f l e s s advanced c l i n i c a l p e r s o n ­ n e l , o th e r court employees, o r i n t e r e s t e d agency r e p r e s e n t a t i v e s — i s r e l a t i v e l y l i t t l e called in to p la y b u t would b e em ployed t o good e f f e c t * Such a program as envisaged n a t u r a l l y c a l l s f o r p e o p le who a r e p a r t i c u l a r l y qualified to assume th e r e s p o n s i b i l i t i e s e n u m e ra te d .

In

s e le c tin g psychological p e rso n n e l, th e s t r e s s w ould be on t h e p e r s o n a l i t y o f th e th e r a p is t, his firs t-h a n d e x p e rie n c e w ith th e t r e a t m e n t p r o c e s s , a b ro ad background coupled w ith s p e c ia liz e d t r a i n i n g and a d e q u a te s u p e r ­ v is e d experience.

In the re c ru itm e n t and t r a i n i n g o f c a n d i d a t e s e n t e r i n g

th e f i e l d , some of the cu rren t em phasis o f a fo rm a l, acad em ic and r e ­ se a rc h n a tu re might p ro fita b ly be ad ap ted t o m eet a l t e r e d n e e d s . Working C o n d itio n s To serve most e f f e c tiv e ly th e p s y c h o lo g is t s h o u ld n o t b e h a n d i­ capped by the necessity of spending tim e on c l e r i c a l d u t i e s , on s lo w , manual t e s t scoring, by the la c k o f th e l a t e s t and b e s t w o rk in g m a t e r i a l s , o r by sh o rt-sig h ted "savings” cm such a n e s s e n t i a l a s i n - s e r v i c e t r a i n i n g * To a ttra c t and hold p eo p le w ith th e q u a l i t i e s , c a l i b r e o f t r a i n ­ in g and usefulness outlined a s d e s i r a b l e , t h e w orking c o n d it i o n s o f t h e p sy c h o lo g ist c a ll fo r improvement.

They s h o u ld c o n t r i b u t e m ax im ally t o

th e p e rso n a l security of the w orker, w h ic h , i n t u r n , r e f l e c t s i t s e l f i n

233 h i s c o n ta c t s w ith h i s p a t i e n t s , c o lle a g u e s, and the p u b lic.

C oncretely,

su ch b e n e f i t s a s t h e a v a i l a b i l i t y o f tenure in secure p o sitio n s a t im­ p ro v e d s a l a r y l e v e l s w hich g iv e f u l l recognition to the amount of tr a in ­ in g r e q u i r e d ; such added b e n e f i t s a s pension p lan s, h e alth p ro te c tio n , l i b e r a l s i c k le a v e p r o v i s i o n s and p a id vacations axe also necessary.

To

h e lp k eep him a t a peak o f p r o f e s s io n a l a le rtn e s s , the psychologist needs tim e f o r p e r s o n a l r e s e a r c h , f o r convention attendance and p a rtic ip a tio n i n p r o f e s s i o n a l m e e tin g s : he m ig h t p ro fita b ly use sab b atical leaves o r o th e r le a v e s f o r tr a in in g o r re s e a rc h .

F in a lly , as a s c ie n tis t, the

c o n d itio n s o f h i s employm ent s h o u ld be h is m erit and the co n trib u tio n s t h a t he can m ake.

The w ork in g atm osphere, to be most productive, must

b e f r e e o f b i a s , i n t i m i d a t i o n , and th e infringem ent of personal l i b e r t i e s .

Sitae s£. Eragraaa A lth o u g h c o n d itio n s p r e v a ilin g in ju v en ile court p sy c h ia tric c l i n i c s to d a y have b een c h a r a c t e r i z e d as f a llin g sh o rt, by f a r , o f what i s n eed ed an d n o t a s c o n d u c iv e t o optim al functioning as might be d e sire d , t h e r e a r e p e r s i s t e n t s i g n s t h a t p ro g ress towards improvement i s being m ade.

T h u s, i n San F r a n c is c o t h e r e i s c lin ic collaboration with the

Y outh A u th o r ity P r e v e n tio n D iv is io n , and in Boston there i s a ra th e r a c t i v e program o f p u b l ic r e l a t i o n s work.

E ffo rts to g et quickly a t

t h e raw m a t e r i a l o f a d u l t c rim e l i e a t the ro o t of the screening plan recommended f o r New Y o rk .

S i m i la r ly , New York and W estchester have

b ro a d e n e d th e c l i n i c a l fram e o f re fe re n c e and devote considerable a t ­ t e n t i o n n o t o n ly t o t h e c h i l d b u t t o the fam ily as w ell. The a d o p tio n o f t h e f a i r l y new group psychotherapeutic methods an d c o n d u c t o f r e s e a r c h w ith them again mark progress in the u n its stu d ied . O th e r r e s e a r c h a s h a s b e e n done i n Columbus, along with the provision fo r

234

the extension of training through interneships as in Columbus and Detroit are encouraging.

The use of trained clinicians of several disciplines as

therapists to help in the numerically immense re-educative task facing the juvenile courts is also becoming somewhat more general.

Finally such special

methods as the visual aids used in a residence training program, the employ­ ment of remedial tutors, speech therapists, and research sociologists, if while limited at present, may be markers in the direction of ultimately bet­ ter clinical services.

Summary Study of juvenile courts and their associated clinical adjuncts has shown that aid to delinquent youth, especially of a clinical nature falls short of what specialists in the field consider desirable.

Existing services

operate within a rather narrow range rendering constructive help to but a small segment of delinquent youth.

In the minority of large city juvenile

coixrts maintaining clinics, half of those agencies limit themselves to diag­ nosis and consultation.

If effective efforts to assist in combatting juvenile

delinquency and mental disease are to be made through a clinical approach, while diagnostic services will continue to be useful, a thoroughgoing treat­ ment orientation should prevail.

To permit this, greatly increased personnel

will be needed, but will then allow for valuable extension of clinical ser­ vices. Thus, the unofficially delinquent would be aided, and a higher proportion of adjudicated youngsters would receive help of a more intensive nature.

Other wards of the court —

the neglected, handicapped, and defect­

ive children would receive more attention, and the problems of the child would be approached through the family to much fuller extent than is done at present. Added personnel would permit the concept of teamwork among

235 clinical staff members to find expression in daily practice and would allow for closer collaboration with other members of the court as well as with interested community agency representatives. tions work of the clinic would be enhanced.

In this way, the public rela­ In addition, as part of the

public relations program the clinic would become more active in training and assume a position of leadership in research. In the process, the clinical psychologist would then be free to function at the highest level of skill along with other members of the clinical team.

Larger numbers of patients would receive such therapeutic

aid as they can profitably use based on techniques developed through more active programs of research. therapist —

Maximal contact between the patient and the

as an accepting person rather than as a threatening figure

would occur, and the psychologist and other team members would become the sources of meaningful emotional relationships essential to the re-education of delinquent youngsters and to the prevention of grave personality disorders. The signs of progress detected among agencies studied suggest that with plan­ ning and aggressive public education, improvements in these vital youth and community services may not be too remote.

CHAPTER IX DISCUSSION Sources Related to the conclusions that are a direct outgrowth of the research, there arise certain problems in connection with juvenile delin­ quency and mental disease, with the courts designed to promote child wel­ fare, as well as with the treatment and methods of those courts.

The In­

vestigator's daily experience with juvenile court cases for almost three years, his clinical background, and a point of view gained in course work with distinguished teachers have led to the evolution of an outlook which, if briefly presented, will provide perspective for the more specific changes and improvements in juvenile court clinic operations just suggested.

GenSS&j .Q.QHfild.er fttlOAg,

The investigator's viewpoint Is not fatalistic: it centers on the concept of multiple-determination underlying mental illness and crime —

as

in all behavior. He feels that the twin problems of the study will not yield to the recurrent blanket prescriptions of slum clearance, religious training, provision of recreational or of clinical facilities, or the censor­ ship of crime movies and comic books.

An approach is essential which stresses

attack on the interacting causes rather than on the symptoms, and entails ultimate modification of the culture which spawns the problems.

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