A child who is moved from an institution into a family situation without any preparation, is likely to be traumatised and this may cause a lot of very challenging behaviour. It has been shown that if children with severe intellectual disabilities, who have lived in an institution for a long time, are moved to a family without preparation, the shock can actually kill them.
So, it is essential to provide proper preparation for the children, when you are planning to move them out of an institution. This blog will look at what that entails.
In previous blogs (HERE, HERE and HERE) you were given information about various aspects involved in deinstitutionalisation, from an organisational and management perspective. Here we are going to look specifically at the guidance given to the children.
Once a plan is in place for deinstitutionalisation, it is important to give the children information about this, in a way appropriate to their age and level of understanding. This should not be done before clear information can be given about what can be expected, because partial information and rumours are likely to create confusion and fear among the children. One of the things that need to be explained to the children early on as well, is that it is not possible to move all the children out at the same time, but that not being among the first children to leave does not mean that they will be left behind or that they are considered less important. It needs to be explained that the very best solution is found for each individual time and that they will leave when everything is arranged for them.
If the child is able to understand what is going on and wants to be involved, she should be made a part of the discussions about her individual plan. This gives her a say in her own life and it helps keep her informed of what is happening. Someone – a caregiver, a counsellor or a social worker – should provide the child with guidance before, during and after these meetings, to help her understand what is going on and to help her voice her own opinions and questions.
Before the child is moved from the institution to the family-based situation – this goes just as much in case of returning to her own family, as it does in case of placement in a foster family or a small group home – she should be given the opportunity to meet with the people who will be taking care of her a few times, so that she can get to know them and become familiar with them before moving in with them. It is also helpful to let her visit the home that she will be living in, to see where she will be sleeping and what everything looks like. And maybe to take her around the neighbourhood to have a look around and to visit her new school, if she is changing schools. All these things make the move much less scary, because she will have an image in her head of where she will be going, before she leaves.
It is important to give the child the chance to ask questions or talk about worries and fears with someone who can give her informed answers about the new situation, in the time before the move. And it can be very reassuring to allow the child to take something – like toys or a stuffed animal – that has been with her in the institution for some time with her to her new home. It will be something familiar in a new environment that can help comfort her. If the child does not have any toys or other items in the institution, giving her something a while before the move, to get used to and take with her, can be helpful. Particularly for very small children and those with severe intellectual disabilities this is an important part of helping the transition.
Aside from preparing to move, it is also useful to provide closure for the time spent in the institution. Although children are generally happy to leave, their time in the institution was still a significant part of their life and should be acknowledged as such. Relationships between children may have formed and the prospect of being separated can be very daunting. So providing the opportunity to say goodbye, before leaving, as well as creating memories and mementos can help make this a little easier. Examples are letting the children write each other little notes, to take with them, taking photographs and giving them to the children to keep, and giving the children opportunities to keep in touch after they have moved.
All together these preparations can help make the transition from institution to family-based care much smoother and less painful for the children. How long this preparation should take varies, depending on the age and understanding of the child. For older children of average intelligence three weeks might be sufficient, while for very small children and children with severe intellectual disabilities – as well as for children who have lived in a room without leaving it or seeing other people for a long time – the process will take a lot longer.
After the child has been moved to a family or small group home, visits should be made by a social worker to see how the child and the family are coping. During these visits the child should get an opportunity to talk about how she is feeling and any questions or worries that she has. And the family should be asked whether they are getting the support they need to cope and if they are struggling in any way. If there are issues, these should be addressed, and solutions should be found to help make things easier.
The transition from institution to a family-based home can be very successful, if it is handled responsibly and sensitively. This is the task before you.
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