Thesis ID: CBB001567369

Emotionally Disturbed Residential Treatment, Child Psychiatry, and the Creation of Normal Children in Mid-Twentieth Century America (2012)

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Doroshow, Deborah Blythe (Author)


Rogers, Naomi
Harrington, Anne
Yale University
Gilmore, Glenda
Harrington, Anne
Warner, John Harley
Gilmore, Glenda
Warner, John Harley


Publication Date: 2012
Edition Details: Advisor: Rogers, Naomi; Committee Members: Gilmore, Glenda, Harrington, Anne, Warner, John Harley.
Physical Details: 472 pp.
Language: English

Starting in the 1930s and 1940s, child mental health professionals embarked on a new experiment to salvage and treat children whose psychiatric needs exceeded the capacity of outpatient child guidance clinics to treat them. This experiment was tied to the emergence of a new type of institution called the residential treatment center (RTC), which offered a therapeutic environment for these children, whom professionals deemed "emotionally disturbed." In many ways, these institutions were extremely heterogeneous. They arose from other types of institutions, including orphanages, schools for the "feebleminded," and training schools for "delinquent" children, varied in size, and treated somewhat different patient populations. Despite these differences, by the 1950s staff members at RTCs identified one another as being involved in the same pioneering project: the treatment of children who had been rejected by their schools, homes, and communities as incorrigible. RTCs, they hoped, would provide a progressive, "non-institutional" therapeutic setting for children who might otherwise have been sent to punitive, custodial institutions. Central to this setting was the therapeutic milieu, an innovative physical and emotional environment which was intended to be a form of treatment in itself. Emotionally Disturbed uses archival sources, unpublished social work master's theses, oral histories, medical journals, and popular periodicals to argue that staff members at RTCs made visible and indeed invented a new patient population. While staff members at outpatient child guidance clinics treated mildly "troublesome" children, RTC professionals identified and treated a group of more severely ill children. As they sought to understand and help "disturbed" children in the 1940s, 1950s, and early 1960s, they explicitly outlined what they believed "normal" children looked like and used "normality" as both a means of treatment and a benchmark for success. By placing children in environments that approximated white, middle class suburban homes and guiding them towards "moderate" behavior that balanced conformity with individuality and creativity, RTC professionals and parents responded to the cultural pressures many Americans felt to strive for an idealized "normal" existence in the decades following World War II. Their image of the "normal" child and his "disturbed" counterpart not only circulated widely through the popular media, but also reflected their daily efforts to transform the most deviant children into "average" ones and return them to their communities as full, contributing citizens. By the late 1960s and 1970s, the community mental health movement, anti-institutional sentiment, increasing costs, and reduced government reimbursement challenged the vitality of a professional enterprise suddenly confronted with a perceived epidemic of childhood emotional disturbance. Meanwhile, several other forces chipped away at emotional disturbance as an organizational category. Autism became a new label for some children who had formerly been "disturbed," special education legislation now counted "disturbed" children as "handicapped," and the juvenile justice system was no longer institutionalizing children who had committed minor crimes or no crime at all. By the late 1970s, many children who might have been treated at RTCs in earlier decades were shuffled among foster homes, schools, case workers, and child welfare agencies. Having lost their institutional base, they had also lost their identity as "emotionally disturbed" children. But for several decades, RTCs provided a unique, therapeutically oriented environment for children who were otherwise considered hopeless, giving them a place to go, a collective identity, and a chance to be a "normal" child.

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Description Cited in Dissertation Abstracts International-A 74/05(E), Nov 2013. Proquest Document ID: 1271996450.


Citation URI
https://data.isiscb.org/isis/citation/CBB001567369/

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Authors & Contributors
Dondici, Danilo
Osamu Nakamura
Monika Ankele
Campaner, Raffaella
Valeriano, Annacarla
Mandelli, Elisa
Concepts
Psychiatry
Mental disorders and diseases
Therapeutic practice; therapy; treatment
Patients
Clinical psychology
Medicine and society
Time Periods
20th century
19th century
21st century
20th century, late
20th century, early
18th century
Places
Italy
Netherlands
Japan
United Kingdom
Iwakura (Japan)
Hamburg-Langenhorn (Germany)
Institutions
Johns Hopkins University, Baltimore
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