San Francisco Chronicle Article Rob Waters

reprinted from Sunday, February 12, 2006 (SF Chronicle)


One Child, One Therapist/An innovative program partners foster children with therapists for as long as they're needed, providing a stability otherwise missing
Rob Waters


When child psychologist Norman Zukowsky first met him, 6 1/2-year-old "William" had already lived through more hardship and trauma than many people experience in a lifetime.


He was born exposed to drugs and alcohol,one of three children of a drug-addicted mother who lived in an unheated garage with no cooking or bathroom facilities.

Child welfare reports suggest that the children were physically abused, exposed to sexual behavior and often went without food or clothing. Eventually, William was
removed from his mother's care only to be placed with a relative who scarred his chest beating him with a belt.

Then William finally caught some breaks. When he was 5, he and his 7-year-old sister were placed with Mrs. Smith (not her real name), a loving, attentive foster mother who ran a stable, orderly home.

Under her influence, he began to settle down and shed some of his wildness and anxiety. One year later, Zukowsky became his volunteer therapist through an innovative San Francisco program called the Children's Psychotherapy Project.

For the next two years, Zukowsky and William saw each other once a week, usually at the therapist's San Francisco office but sometimes at Smith's tidy blue house. Zukowsky saw in William an endearing, charming boy who was hungry for adult friendship and connection.

They spent most of their hour-long sessions playing cards, board games and improvised baseball using paper wads and pencils. "He made the rules ... he kept score, and he always won ... repeatedly, inevitably, and -- in my clinical view --necessarily," Zukowsky wrote in a chapter of a recent book about the psychotherapy project.

William was playing "developmental catch-up," Zukowsky wrote, seeking and getting from his therapist the warmth, attention and emotional nourishment he had missed in his earliest years.

Things were going well for William. He had fallen in love with his foster mother, who was in the process of adopting William and his sister. He adored Zukowsky. And he was doing well in school.

Then, one horrible night, William's life crumbled again. Mrs. Smith's husband, a depressed, quiet man who rarely interacted with the children, shot his wife and himself. William and his sister found their bodies and lost the only stable, loving home they had ever known.

Zukowsky was now the key adult in William's life, the one person he could
count on, and who was truly looking out for his needs. Zukowsky was in that position because 12 years ago San Francisco psychologist Toni Heineman got mad about the many ways the child welfare system fails foster children -- and decided to do something about it.

Heineman had worked with foster children for many years and had learned firsthand how the system sabotages the ability of foster children to form lasting relationships with caring adults.

"We send foster kids from home to home, community to community and case worker to case worker," says Heineman, an associate clinical professor of pediatrics and psychiatry at UCSF. "It's the biggest problem in the system."

The system's failings take a heavy toll. A recent report from Casey Family
Programs, a foster care agency, found that former foster youth now in their 20s and early 30s suffer from staggering rates of post-traumatic stress disorder and other mental health problems; high rates of unemployment, homelessness and poverty; and low rates of college and vocational school completion.

Heineman realized that revolving therapists were part of the problem. Foster children who get therapy usually are seen by interns who rotate every few months to get diverse experience. Just as a child forms an attachment with a therapist, she explains, the therapist leaves and the child is once again abandoned.

To address this problem, Heineman and a group of colleagues founded the Children's Psychotherapy Project, which recruits therapists to spend one hour a week working with a foster child.

The guiding principle is simple: "One child, one therapist, for as long as it takes." The project asks for a long-term commitment from the therapists it recruits, but it also gives something back: In addition to their one-hour session with a foster youth, each volunteer therapist also participates in a weekly consultation group led by a veteran clinician.

These groups, which therapists might normally pay to attend, allow colleagues working with children to come together, discuss cases and get advice and support from each other.

After Mrs. Smith was murdered, Zukowsky's consultation group became a crucial source of support for him as he mourned her death and its impact on William. "I was sustained by the emotional sharing" of the group, he wrote.

Zukowsky's role in William's life was now more critical than ever. He comforted William, worked his connections in the welfare system and strategized with the therapist working with William's sister, also a project volunteer. When they resumed their sessions, a subdued William continued to want to play -- and did not want to talk about his foster mother's death. Zukowsky followed his lead, rarely bringing up Mrs. Smith's death.

William eventually recounted the story of finding the bodies, the shock and sorrow playing briefly over his face. Eventually, William brought up the question Zukowsky had been dreading: Perhaps, the boy asked, they could live together. Zukowsky awkwardly explained that would be impossible, and William let it go.

Today, two years after Mrs. Smith's death, William and his sister are again living in a stable home. William is now 10, and he continues to see Zukowsky once a week for sessions of indoor basketball mixed with a bit of talk. Zukowsky is guarded and self-effacing when he talks about William and his impact on one boy's life. But this much, he will say: "In a psychological sense, I was family. We shared a loss, and he had someone to lean on."

The Children's Psychotherapy Project, meanwhile, has gone national. From its start in San Francisco, the project has spawned 12 chapters in cities around the country.

More than 100 therapists are donating their time and more than 200 foster children have been served. In a system that, on any given day, includes some 500,000 children nationwide, that number is a drop in the bucket. Heineman keeps on working to recruit more therapists and serve more children. But whatever the numbers, she believes the program has an impact beyond the individual children served.

"When we make a difference in the life of one foster kid, it also has an impact on the system," she says. "It's small and it's subtle, but over time, it adds up and people begin to think about the importance of long-term relationships in the lives of foster youth in a different way."


Freelance writer Rob Waters is a recipient of a 2005-2006 Rosalynn Carter
Fellowship for Mental Health Journalism. ----------------------------------------------------------------------
Copyright 2006 SF Chronicle

Another Day in Family Court

Mom (Carol) was in court today with her daughter (Ann) even though mom’s parental rights were terminated seven years ago.

The social workers and I thought that there might be a mutual benefit for mother and daughter to reattach (supervised visits with a therapist) after all these years because Ann was such a mess and there appear to be few choices left for Ann.

Ann has been having sex in cars during High School, unable to read at a third grade level, and other even more dangerous and illegal activities over her fifteen years (cutting herself and prostitution).

Her mom was all cracked out when I first met her eight years ago. On my first visit she caused the evacuation of her apartment building with a grossly stupid act. She started a fire and told no one about her mistake causing great chaos because of her refusal to bring attention to where the fire was. I could only observe her behavior with wonder and sadness. Crack really does own the user.

Over the next few years I (as the guardian ad-Litem) removed five children from Carol in three separate family court hearings. Cocaine was present in the blood tests of several of her children (they had been given cocaine as very young children), and there were obvious signs and extensive reports of sex abuse to the oldest daughter and at least one violent beating of this child by “uncle" Tim”.

All Carol’s children showed severe signs of abuse and trauma. Tim was implicated in most of this abuse.

I had told the judge at the time that Carol and Tim belonged in jail for what they had done to these children. The judge and my supervisor explained that criminal charges would complicate the removal of these children from their toxic environment, so I relented.

I was told that seven years olds are not credible witnesses in a courtroom. I have since then found out how impossible it is for seven year olds to find justice in our legal system (they just don't hold up under cross examination).

Carol now has two children under four years of age. In the course of several hours of my investigating her living conditions to see if visitation with her very needy daughter should be recommended, it was discovered that her oldest child (four years old) has been ingesting cocaine. There is also a police report of sex abuse of this child by an uncle. I saw Tim on my visit the last time I was there.

Waiting outside the courtroom alone with Carol, I asked her if she had any idea of the long-term impact of sex abuse and cocaine use upon her very young children. She asked me why I had been chosen as the guardian ad-Litem for her two youngest children. I said I thought it might be because I knew her family history.

I wonder how many children Tim has abused in his life?


Our courts, schools, and children badly need our understanding and attention.

Call your state representative or send a letter (copy one from my website: www.invisiblechildren.org ).

Worth Reprinting

State must make early childhood investments a priority

KELLY DORAN

During a speech in Hong Kong near the end of his China trade mission late last year, Gov. Tim Pawlenty expressed his amazement at the "scope" of China's rise to economic superpower status. Then, in an apparent moment of sober revelation, Pawlenty reportedly proclaimed that it is about time "for our country to get its rear in gear."


It's hard to imagine how Minnesota's governor could be so seemingly blindsided by what business leaders and policy experts have been warning of throughout the past several years — the global economy is on the move, and in order to maintain our competitive edge and grow Minnesota's economy, we need to have a vision for our future that includes investing in education like never before, in particular early childhood education.


If there is one direction in education toward which Minnesota should move, it is reforming our education system and ensuring every child in Minnesota has at least one year of education before entering kindergarten. Study after study has proven that early childhood education is an almost guaranteed way to ensure greater success later in life.

Whether our goal is to increase the graduation rate of our high school seniors, close the achievement gap between white students and students of color, or increase the number of our high school graduates who go on to earn a college degree, there is no greater investment we can make than in early childhood education. According to recent studies, investments in early childhood education can even lead to less crime and decreased welfare payments.


Leaders across the country are taking note. Take a drive down Interstate 35 to Iowa, where the governor and Legislature have dedicated more than $75 million for early childhood initiatives over two years. Head further south, and Arkansas' Republican governor has passed two tax increases for such an investment, while two other conservative states — Oklahoma and Georgia — provide free state-paid preschool for every 4-year-old child.


Here at home, Art Rolnick of the Federal Reserve Bank of Minneapolis, hardly a liberal think tank, touts investments in early childhood education and insists such spending offers the greatest return on investment available to government.


Yet, unfortunately, under Pawlenty's administration, support for early childhood education initiatives like Head Start has been cut by many millions of dollars. And though early childhood education has both proven results and unparalleled returns, we now dedicate only 0.5 percent of our state budget toward this investment. If the CEO in the business world suggested investing such a minuscule amount in a proven high-rate-of-return investment, he or she would be fired.


In the meantime, as the governor and lawmakers gear up for the new year and new session, debates about whether to extend the school year and reorganize how we pay teachers have occupied our public discourse. And while these are fine debates worth having, we need to have a broader debate and ensure we are building the necessary foundation for our children to be successful and seize the opportunities of a global economy.


What the governor witnessed in China was a society that has a clear vision, is focused on its future, and has made purposeful and unprecedented investments in education infrastructure. China has more than doubled its number of college students in the past five years to 14 million, the most in the world. It is producing eight times as many graduate engineers as the U.S. Chinese government officials recently announced to business leaders around the world that the country will significantly increase its investment in education as a percentage of the country's GDP.


China's potential to overtake the American economy is real, and it could happen in our lifetime if we don't prepare our children and our economy for what lies ahead and ensure we can compete.


A Chinese proverb reads, "The person who doesn't worry about the future will soon be worrying about the present." It's time to set aside politics and do the right thing.


Doran of Eden Prairie is a DFL candidate