Introduction

With this paper I would like to explain you how the Panta Rei Centre works, and how it operates with public services through its involvement in two different projects we are working on in Saronno and Varese, both cities in the north of Italy, near by Milan.

I’d like to give you a little information about the organisation of the social and health services in Italy, and how they look after children and families with low or extremely low economic and cultural levels. There are two principal fields in public services in Italy: the Health Services and the Social Services.

The Health Services deal with treatment, with therapies, with pathologies and, in a way, we can say, with change.

The Social Services deal with assistance, with economic help, and with both the Young and Adult Persons’ Courts.

Again, over recent years, both culture and legislation note the importance of the natural family. They suggest helping to rehabilitate the natural family or adoptive and foster families.

Indeed, as expressed in our recent laws:

"Support services for parent-child relationships, in contrast to poverty and violence, indeed, alternative measures to taking minors into care" art.4, law 285

and:

"…..prevention and assistance in cases of abuse, whether sexual, abandon, mistreatment, and violence on minors;….family mediation services along with counselling for families and minors in order to overcome relationship difficulties"

Our Project Hypotheses and Motivations

After several years of work carried out by the local Social Services, some research results indicate the appearance of needs to which no answers have yet been given

• the high number of minors taken away from their families and put into care, such as special institutes and group communities
• the lack of parental guidance due to negative family organisation or to the adults’ inability as parents
• longer and longer fostering, and fostering that comes to an end with an administrative expiry date – the minor is 18.
• the psycho-social support for the natural family carried out by social workers is not always successful, because of the necessity of back-up from specialist therapeutic work
• the difficult integration of Social Services and Health Services, with the consequent fragmentation of the work on one family unit
• the lack of foster families for older children
• the lack of integration due to insufficient mediation of cultural differences
• the difficulty in obtaining resources and support suitable for the needs of minors, with the consequent operative delays
• the costs are too high for the results obtained

The fundamental elements of the project may be summed up as follows:

- Firstly, Early Detection

It is important to act rapidly in situations that show signs of existing problems, so that the minor is exposed to the effects of psychological suffering as little as possible, and any harm incurred may be rectified more quickly; it is equally important to interrupt those interactions between the family, the community and the Services, as they often lead to the drastic lowering of the level of the family’s self-esteem, as well as negative social labelling, both becoming more chronic as time passes.

-Secondly, Transitory delegation of parental functions and the rapid return to the natural educators means that, along with early detection, there is the idea that the educational delegation granted by the parents, or asked of them in moments of difficulty, must be handled with particular attention, in order to keep the parental desire to solve the problem active, and, to have time to work on any remaining family intentions of recuperating and maintaining relationships. The intervention must be properly aimed at the rehabilitation of the family functions in such a way that the period of "ill-health" is as brief as possible and the "convalescence" involves the activating of all existing potential, however "weak" it may be.

-Thirdly, Interventions timed on objectives

The subject of time and timing is fundamental from an economic point of view, as well as from the educational aspect. To define intervention times and to designate the objectives with precision, allows the minor and, above all, the family to feel a sense of involvement in the operation, including them in the process of calculating the worth of the work to be done, so guaranteeing transparency for one and all, and guarding against institutional mistakes. In economic terms it means paying constant attention to the efficiency of the activities.

-Fourthly, The lowering of costs

We can do this by housing the child away from the family as rarely as possible.

-Fifthly, Intervention proposed to the family and with the family

The fundamental idea is that the best intervention possible for the minor is that presented to the family as a whole and, above all, in which the whole family is involved as protagonists, the actual partners of the Services, in the construction of the project, though being the "object" of the operation. The family must become the centre of action in situations that are deliberately set up to get over relationship difficulties, and / or to circumscribe the acclaimed pathology, so that an acceptable and adequate area to be helped in can be found.

-Sixthly, The co-ordination of mixed resources

The network that is spontaneously activated or that can be stimulated to help the minors, represents the true instrument of this project. Naturally it needs to be co-ordinated in such a way that there is a communication management that keeps the network together in a balanced way, yet defined in position and responsibility.

The support activity of the project is the intervention of home educational assistance which, once agreed upon, is carried out in the minor’s home by a professional educator. It is aimed at the rehabilitation of family relations, with particular attention to the functions of the parents, and to support the minor in the context of the family reality.

Following an agreement between the family and the Social Services, the educator will begin to frequent the family unit, so getting to know the minor, and identifying, in the daily running of things, both the inadequacies of family resources and the remaining potential of the parents regarding their children. A developing process will result, which, from one point of view may be a different educational model and, from another, a stimulus towards change in rigid roles and family dynamics.

The professional educator fits in the home education operation like a novice Mary Poppins, entering the family with an explicit job to do and evident intentions, temporarily integrating into family relations, specifically in the interest of the minor, but with the collaboration of the adults. The family will be left when the educator feels a seed of transformation has been introduced.

In close connection and integration with the previous activity, a social-psychological service is set up for the family.

The social-psychological service for the family requires certain characteristics for its organisation in order to fit some needs: the low cost of work done, the quality of work, acceptance of the quality and efficacy of the work, specific essentialness of the work.

The necessity of specialist intervention with the family, together with other resources of the Social Services, evolves from some considerations

• families that approach the Social Services only asking for economic help sometimes have underlying problems of another kind
• most families show relationship difficulties which may be transitory or chronic
• there are very few families that "pass through" the Social Services, many, indeed, become quite "at home" there.
• such characteristics are often associated with difficulties that go beyond a social level, indeed becoming pathological relationship problems

• fostering, home educational assistance, and stays in special communities must be

accompanied by a change in the human systems within which the difficulties have

developed, otherwise such interventions give only transitory support

• such support, along with Social Service help already given to the family, does not always promote the changes considered necessary for an adequate carrying out of parental functions

• specialist treatment for families with multiple problems, or with low social-economic standing is almost non-existent in the Health Service – which has to deal with diagnosed pathologies, rather than suspected ones.

• such treatment is possible as many years experience abroad and in Italy reveal

• treatment of these families however requires competence and specific procedure, also considering the fact that, very often, the families themselves do not readily ask for such specialised interventions of therapeutic value

• in the present situation that is characterised by the strong influx of immigrants, the necessary competence for working with the above-mentioned families is an ever more useful heritage

The minimum functions that must be present in the Social-Psychological Service are:

• Social-psychological counselling

This exists in some activities normally carried out by the Social Services, and is aimed at "less problematic" cases that turn to the Social Services with an existing psycho-relationship question

• Family mediation

Aimed at and prepared for the characteristics of cases that do not match the usual ones undertaken by normal family mediation services, so being highly emotional and implicit cases that are full of conflict. This means using family mediation techniques in difficult situations

- Cultural mediation

Knowing the difficulties that mainly originate from cultural differences leads us to consider this service not only as useful in solving family conflict, but also solving that which may generate between social workers, and the like, and their clients

• Family therapy

Reference is made to experience gained from family treatment that goes beyond the rigid setting which is often present in psycho-therapeutic health services. These services are often organised to answer to the middle and lower-middle classes, of average schooling and who are quite well integrated, socially and culturally. Generally speaking, psycho-therapy began as a cure for the upper-middle class. In recent years the development of the Social and Health services has favoured the building up of treatment experience at all different levels of society. Up to now though, the presence of setting organisation and suitable intervention techniques for families that belong to social classes with poor language skills, poor relationship styles, and highly emotional reactions, including the "usual" distinct pathological symptoms, are still scarce. The family treatment we propose tries to relate, more carefully, to the needs of the families that represent the Social Services community.

• Neighbourhood therapy

We refer to a specific intervention procedure (Speck, Attneave), which foresees home meetings with the family group, relatives, neighbours, voluntary workers or other significant persons who aim to activate the resources that are to be found within that micro-community network. These meetings will be held by two or more specialists.

What results has the project obtained?

Two and a half years have passed since the project started and only one year since the introduction of family treatment. We now ask what effects our activities have had.

In order to help, we must distinguish:

the effects on the family, our clients

the effects on the Service workers

the effects on administration

the effects on the relationship between the Services and the clients

I point out that this is a distinction made only to help my talk.

The first area represents our higher ambitions, that is to build changes in relationships within the family: it is also the area of major frustrations.

We know that it takes a long time for change to take place, the construction of change takes time, especially changes that are visible in a social context.

We can certainly say that there where no violence or abuse is present, our less dramatic situations, we are beginning to see the seeds of change. This gives us faith in the project.

The greatest change is to be found in the Social Workers: preconceived ideas seem to change, above all those ideas with which they enter relations with the clients and the consequent attitude in the relationship.

They don’t seem to judge, they are curious to understand an existential perspective that is so different to their own. They enrich that vision within themselves of the person – having less restricting images of the deviant behaviour – and this extends to the ways they cognitively and emotionally face the so-called normal events in life which are the same for all of us. Lastly, they recognise and live their role of social control together with that of assistance and help more clearly.

It’s important for these experimental projects to be approved of by administrators, so that we may have easier access to human and economic resources. The lowering of costs, not having to take the minor into care, or at least the stability of costs in relation to the increase of the services which are offered, has allowed us and allows us to continue our work and motivates ulterior innovation.

Certainly, the main effect of the application of our model is to be found in the relationship between the clients and the social workers.