Delinquency in Children and the Method of Treatment in a Child Psychiatric Unit
Manley, I. D., New Zealand Journal of Occupational Therapy
This paper was read in November, 1967, at a Study Day, the subject of which was "Delinquency" held under the auspices of The Scottish Association of Occupational Therapists, in Glasgow.
Manley, I. D. (2010). Delinquency in children and the method of treatment in the psychiatric unit. New Zealand Journal of Occupational Therapy, 57(2), 72-76. (Original work published in 1967).
The children treated at Ladyfield are of primary school age. Two-thirds of them are of average intelligence and one-third be1ong to the educationally sub-normal group. These children suffer from a variety of emotional and psychiatric disorders, psychoses, neurotic disorders, organic brain damage or disease, reactive behaviour disturbances, epilepsy, psychosomatic and personality disorders. Of the children who come to Ladyfield, only a relatively small proportion, not more than one-third, are delinquent or likely to be delinquent. There are no exact figures for the relationship of delinquency to psychiatric disorder in primary school children, but from statistics of adult person populations and those of approved schools, which show remarkable agreement, it is reasonable to assume that about 25% of delinquent children of primary school age have obvious psychiatric disturbance.
These are children in whom delinquency has been evident when they were very young, from six to nine years of age, obviously too young to go to an approved school or when in older children the delinquency forms part of a severe behaviour disorder with obvious emotional disturbances. It is therefore a selected group and the treatment offered is an attempt to meet the need of these children. The children who have been diagnosed as behavioural disorders often come from deprived and disturbed backgrounds. They have deep seated mal-adaptive patterns of behaviour and present problems of stealing, truanting from school, running away from home, telling lies, larceny, house breaking, and excessive aggressiveness and destructiveness. Their relationships with people within their own family group, their neighbourhood, and their school are distrustful and actively hostile. They appear to have little capacity for learning from past experiences and for modifying their behaviour to avoid foreseeable pitfalls. They often come to us with a description of having little or no capacity for affection and a lack of trust in people, particularly adults, and they are not influenced in their behaviour by the possibility of pleasing them.
The 56 residents in The Children's Unit, together with about 10 day pupils are divided between three houses, near to each other, with extensive grounds. The hospital staff consists of doctors, nurses, psychologists, psychiatric social workers and two occupational therapists. The school is staffed by teachers supplied by the local education authority. The life of the children is very like that of any residential school. They go home for holidays and wherever possible for weekends. A constant interaction between the family and the unit is maintained by the social workers and doctors. The nurses are responsible for the day to day care of the children, and a great deal of re-education in terms of upbringing. The individual therapy is shared by the doctors, psychologists and occupational therapists, and the occupational therapists are entirely responsible for the group therapy. It is this aspect of the treatment which I wish to describe.
Group therapy in Ladyfield is based on the saying, "Two's company and three's a crowd". The children are perhaps the most disturbed in Scotland and to meet their needs the group is kept small. It is in part a very natural setting and the closest the child gets to the family situation within the residential unit. The main objectives in group therapy are:
1. To give the child an opportunity to form a close and meaningful relationship with another child and an adult. …