II. The Potentialities of Family Oriented Counseling What are the implications of the foregoing to anyone trying to understand the behavior of the blind child with developmental problems and to be of help to his troubled parents? A first principle must be recognition of the particular vulnerability of both the blind child and of his parents to the stresses inherent in all family life. Herein rests the challenge to the skills of the professional worker as he attempts to find ways of breaking into the vicious circle of frustration, hostility, and hopelessness. One thing seems clear that service must be family oriented and not blind child oriented. There is an increasing body of experience which demonstrates the possibility of freeing the potential of blind children with severe developmental problems and of helping parents as they face the demands of a child whose behavior has been so unrewarding to them. The person who is placed in the role of counselor to the family must first have a real conviction of the worth and potential of all individuals. He must have a respect for the uniqueness of each individual and a knowledge of the dynamics of personality and family interaction. He must also understand the cultural and social factors in behavior. He must have an awareness of himself as a person and of his biases. To help others in periods of stress the "counselor" must be secure in his own role as an individual and as a professional person. He must have resolved his own feelings about physical impairments and more specifically society's stereotype around the loss of vision. He must be able to reflect warmth and understanding; he must be objective without being detached and have feelings without being emotional. He must have the ability to accept and understand feelings and to handle hostility directed at others and at him without being punitive and hostile in return. In summary, to be in the helping role the person must be a mature professional person whether his special discipline is social work, psychology, education or medicine. The counselor may work in a variety of settings. But the primary function is the same; to relate to the troubled parents in ways which will help them move ahead with confidence in the day by day tasks of planning for their child and encouraging his development within the framework of their own family situation. In a very basic sense the counselor shares their problems and serves as a resource on whom they can depend for help in the problems that at any particular time seem uppermost to them. Ideally the initial contact should come at the time of diagnosis. In one medical setting for example, it was the practice of the ophthalmologist to call in the counselor-in this instance a medical social worker-when he was examining the baby's eyes under anesthesia, pointing out to her the pertinent facts of his diagnosis and then including her as he talked with the parents. When this occurred, the doctor's confidence in the social worker and her knowledge as demonstrated in the shared experience served to establish a point of contact which was invaluable in her work with the family. Rarely does this happen but in every situation it is the responsibility of the counselor to find and establish a point of contact as the basis for a helping relationship. Many times the parent comes only after he has experienced indifference and misunderstanding at the hands of many people. The counselor also recognizes the tremendous value of listening sensitively, taking clues from the behavior of the parents before assuming that a more active role will be helpful. As one teacher phrased it: "The counselor has to be a genuine resource person, not a threat to the adequacy of the parents.' The counselor should be able to communicate some understanding of the way blind children grow and develop but experience has demonstrated that each parent has to find his own way of apply ing a principle and that no one else can tell him "how" to do it. The timing of the giving of information is based on the parents' readiness to use it constructively. This timing requires judgment and skill. To suggest something that the parent cannot do is only to create still another frustration and to lessen his ability to meet the needs of the child. Sometimes it is essential to suggest something a parent can do with assurance of success no matter how insignificant it may seem to be. Showing appreciation of the mother in her maternal role may enable her to consider various ideas and come up with her own solutions. During the process of observing, understanding, and helping, the counselor will need to know all the resources in himself, his profession, the family, other disciplines and the community, and use them constructively toward the end of strengthening the family and helping restore its balance. However, in utilizing community resources, the wise counselor will understand that he must have a comprehensive inventory of such services and their currency and appropriateness as they apply to serving a family in which there is a blind child who has developmental problems. The experience of the parents of blind children, particularly the children who are severely disturbed, in obtaining constructive help from community resources, has not always been a positive one. Too often these resources have held the same stereotyped attitudes about blindness and the behavior of the disturbed blind child that is characteristic of the lay community. If these stereotyped attitudes cannot be modified, experience in using the service may prove may prove destructive both to the family and to the child. The following are actual examples of advice given indiscriminately to parents when it was learned they had a blind child: • "Commit him early so you won't get attached to him." "Special educational and remedial programs are not necessary; • "All he needs is love, and he will grow normally." However, referral to other community services-health, welfare, and education—is an essential part of the service the counselor gives to the family. These community services are theoretically established to provide for the major function indicated. They may include the following, not all of which will necessarily be found in every community. 1. Family and Children's Services: provide professional skills in resolving interpersonal tension in the family and preventing family breakdown. 2. Homemaker Services: relieve the mother of burdensome household tasks and allow her more free time to give to interpersonal relationships with other members of the family as well as with the blind child. 3. Foster Day Care: provide care for the child outside of the home during part or all of the day, when such an arrangement seems necessary for maintaining family balance or for meeting the blind child's needs for short periods of time. 4. Foster Home Services: provide for a longer period of separation from the child's own family when advisable. 5. Public Welfare Programs: meet the economic needs of the family for periods of time when necessary. 6. Preschool Programs: provide social experiences where the young blind child with severe adjustment problems will be accepted as he is, and will be able to participate in a group with his peers. 7. Educational Programs: provide the blind child with an education at least equivalent to that which he would have had in his own community if he were sighted. 8. Volunteer Services: supplement many of the above services under professional guidance. 9. Medical and Psychological Services: diagnose and appraise the child's potential, problems and progress. In securing any of the above services in behalf of a family the counselor is most effective in the role of coordinator of all effort in behalf of blind children and their families. A comprehensive program cannot develop easily in a community where segments of the total family situation are ignored while undue emphasis is given to an isolated part of the child's needs on the basis of an agency's specialization. Careful coordination on the part of the counselor should insure that service is family-oriented. In referring parents to other services, the counselor should secure their full cooperation before the referral. The procedures should be planned with both the parents and the service to which referral is made. The agency accepting the referral should keep the counselor informed of the progress of the situation from its point of view, as well as of any additional referral contemplated. This clearance is necessary if the interests of the family are to be protected. In preparing written reports for other agencies the counselor should include only such information as is pertinent to the needs of the situation and the agency goals. The principle of confidentiality of the material is, of course, implicit in this type of professional service. A community resource which may enhance the developmental opportunities of the young blind child is the nursery school. It can function under various auspices and be organized in a number of ways; the details of the program may differ from school to school. Some schools offer primarily a supervised play opportunity in a desirable setting and relaxed atmosphere for a group of preschool children. This type of operation, carried on for an hour or two per day, may adequately meet the needs of the young preschool child, or the severely disturbed one, who has not yet learned to tolerate a more highly organized program. When a counselor is considering a nursery school placement for any child, but more particularly for the disturbed blind child, careful planning is essential. He must ask himself if the parents as well as the child are ready for this step. Locating the kind of nursery school suited to meet the child's needs at the time should be a matter |