Control

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Controlling Janet?1

Terry A. Wolfer

After parking the county station wagon, Marie Johnson walked slowly toward the administration building at Oak Hill, a residential treatment center for adolescents. It was a beautiful, sunny day, with a clear blue sky in fall 1993. While waiting at the main office, Marie could see Janet Oswalt approaching with a staff member. Janet was walking with her shoulders bent down. The 14-year- old wore ripped black fishnet stockings and a black skirt that she had cut unevenly. The shoulder of her black silky shirt sagged, exposing a bra strap. She had splotchy black makeup under both eyes. With a quick look, Marie guessed where this meeting was headed. She felt tired before it began.

Marie held the door open as Janet arrived and silently escorted her into a private office. Janet slumped into a chair, then blurted, “What the fuck do you want?” Before Marie could answer, Janet said, “I’m not going back to that bitch! She loves Mike more than me.”

Cautiously, Marie ventured, “Can you tell me what happened last night?” “I don’t want to talk about it,” Janet announced defiantly, and as abruptly as

the angry torrent began, it ended. Where do we start, and where do we go from here, Marie wondered silently.

Stanislaus County Department of Social Services, Special Placement Unit

Located across the mountains east of San Francisco, in Modesto, California, the Stanislaus County Department of Social Services (SCDSS) provided a range of child welfare services for dependent children. The Special Placement Unit (SPU), with four professional staff members, focused on some of the more challenging children in agency custody. Like the rest of the agency, it adhered to permanency planning philosophy and worked within parameters set by law. But for the older children it placed, family reunification was often unusually complicated, messy, and sometimes impossible.

Marie Johnson

Marie Johnson had spent 2 years as a foster care caseworker in the Special Placement Unit, her first position after earning the MSW at the University of California (Berkeley). Because she had gone directly from college to graduate

1 Development of this decision case was supported in part by funding from the University of South Carolina College of Social Work. It was prepared solely to provide material for class discussion and not to suggest either effective or ineffective handling of the situation depicted. While based on field research regarding an actual situation, names and certain facts may have been disguised to protect confidentiality. The author thanks the anonymous case reporter for her cooperation in making this account available for the benefit of social work students and instructors. Copyright © 2004

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school, it was also her first full-time social work position. Fortunately for Marie, one of her graduate field placements was at a residential treatment center for adolescents so she was quite familiar with their mental health needs. She was also bright, a quick learner, and the type of person who threw herself into a new job. For the most part, this job had been a good challenge for her and, as she told friends, “a great place to begin my career in social work.”

Something Marie enjoyed most about the job was the regular contact with a wide variety of community professionals. Work with particular youth sometimes required that she communicate with school administrators, guidance counselors and teachers, attorneys for families or the agency, juvenile court judges, the police, and emergency shelter staff. But she especially enjoyed working with other mental health professionals, including those from Stanislaus Community Mental Health Center, Oak Hill Center, and other group facilities, as well as school psychologists, several psychiatrists, and assorted private practitioners. All these people provided a fascinating learning context.

The Fax Alert

Earlier that morning, on reaching her DSS office minutes after 9 A.M., Marie had immediately noticed a fax from the child abuse hotline lying on her chair. She picked it up to see what had gone wrong. As a caseworker assigned to the SPU, she only received these faxes when there was a problem with one of her ongoing cases. This one referenced Janet Oswalt. Because Janet was already a dependent, and this was not an allegation of abuse, the form was scarcely filled out. In the allegation box at the bottom, the intake screener had summarized a phone call from Janet.

“Oh, no!” Marie spoke softly as she read. “This, this is not good.” Then, almost flippantly, “Oh, great, I had plans to go visit the Oswalt kids anyway but I guess I have something else to focus on now.”

Disappointment welled up because Marie had repeatedly encouraged Janet and her mother, Paula Oswalt, to let Marie know first before they reached a crisis. She just didn’t want to get to the point where a kid was so angry that he or she became physical and had to be moved. She had often reminded them, “Call me, use the on-call worker, use the therapist, use the on-call therapist, don’t let it get to a crisis. We’re here to help you.” Now, shaking her head in frustration, she muttered, “Oh, why didn’t they call first? After all that work, the placement blows up.” But almost immediately, she felt guilty because her team had not arranged outpatient mental health services fast enough. “Well, I guess we have to go in there and somehow figure out what to do,” she told herself. “Whether they live together or not, we have to start over, to rebuild the relationship.” Marie felt sure this could have been prevented. But first, she needed to know what had happened.

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Burger King Incident

As Marie eventually learned, Janet and her family had gone to dinner at Burger King the night before. The family included Janet, Janet’s three younger siblings, her mother, and her mother’s boyfriend. Janet started talking about African Americans, making loud, racist comments. Partly because there was an African American in the restaurant, her mother’s boyfriend felt uncomfortable with Janet’s comments. After glancing at Paula, he started to reprimand the girl, “I don’t care what your beliefs are, you don’t talk like that in public.”

She snapped back, “You have no right! You’re not the boss of me.” Their disagreement quickly turned into a quarrel, and the two adults decided the family should leave the restaurant.

Now the kids were angry with Janet, too, because they knew her behavior caused this conflict and ruined their outing.

After they arrived home, Janet went to the phone to call the hotline operator for child protective services. Janet gave her name and address, said that she was in agency custody, and matter-of-factly explained that she was going to kill her mother’s boyfriend. Then she hung up, went outside, and tried to slap him. At this point, Paula grabbed her and tried to restrain her.

Because of the phone call, the police came. Janet told them angrily, “I’m not going to live here anymore.” The police reacted by pulling her from the home and taking her to a shelter for the night.

Family Problems

The Burger King incident was a relatively minor one, the latest in a series of problems for Janet. Her mother and father divorced when she was 5 years old. Following the divorce, Janet and one of her younger sisters lived with their father and paternal grandparents in Nevada for one year. However, Nevada child welfare officials removed them from the father’s care by after the sister reported that she had been sexually molested. At the time, Janet denied any similar abuse.

After being returned to Arizona, Janet and her siblings moved back and forth between their mother’s and their maternal grandparent’s homes. During this period, Paula was drinking heavily and became addicted to cocaine. As a result, she was often unable to provide food or shelter for the family. Although she resented their involvement, Paula frequently requested help from her parents to meet the basic needs of her children. Despite their help, Paula could not maintain a household and the family eventually became homeless.

While Paula lived on the streets with her boyfriend who was also addicted, she left all four children in the care of their maternal grandparents, Mr. and Mrs. Dunleavy. Shortly after moving to this household, 11-year-old Janet began to behave in ways that troubled the grandparents. For example, she cut her hair

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into a Mohawk, dated an 18-year-old man she met at a city park, recited Nazi and hate propaganda, and began to cut herself, usually on her forearms and legs. Concerned over her behavior, school officials referred her for psychological assessment. A school psychologist diagnosed her as suffering from severe depression. As a result, the school placed her in a special education class for emotionally disturbed children. As part of this class, Janet received weekly individual, family, and group counseling from a school social worker.

Janet resented being placed in a special education classroom, believing that middle- and upper-class peers saw her as inferior because of it. She began to make threatening gestures toward herself and classmates. The Dunleavys, who did not believe in therapy, expressed little hope of curbing her self-destructive behavior and seemed resigned to accepting it.

Soon after her 12th birthday, Janet disclosed that she had a plan to commit suicide. After learning this, the school social worker initiated a psychiatric hold and arranged for Janet’s admission to Charter of Phoenix, a local private psychiatric hospital. At Charter, Janet continued to talk about committing suicide, so the hospital extended the hold for 21 days.

Child Protective Services Intervenes

Because Janet’s grandparents had never been given legal guardianship, they were not able to legally act on her behalf nor could they afford to pay for Janet’s hospital stay. Therefore, the school social worker made a report to child protective services. As a result, the family court made Janet and her siblings dependents of the court and initiated family reunification services. The grandparents agreed to keep the younger children but, because of her increasingly dangerous behaviors, refused to accept Janet back into their home. Under authority of child protective services, the hospital discharged Janet to Oak Hill. Soon after Janet was placed at the center, Marie became involved with the Oswalt family.

Paula Oswalt

After hearing all the raving reports about Paula’s progress, Marie could never forget the first time she met Paula. Nearly 6 feet tall, Paula was slightly heavy. The first thing out of Paula’s mouth was, “I stood before the judge and the judge said if I didn’t follow through on the service plan I was going to lose my kids. I thought, ‘I never meant for it to get this far, and I’m not going to let this happen.’ ”

In fact, drug rehab program staff described Paula as a model patient, one who took the drug rehab program seriously and used it to turn her life around. Paula got herself into this particular program by calling every day, advocating on her own behalf. She was actively engaged both in her program and outside

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Narcotics Anonymous (NA) groups, passing her random drug screens every time. She attended all the parenting programs offered. In addition, she participated in weekly family therapy with Janet and separate sessions with the other, younger children. After completing the drug program, program staff even invited her to stay on as a resident mentor to the new mothers coming in. In that capacity, she was allowed to have one or two children living with her, so she took in the two youngest children who had been staying with the maternal grandparents. Although staff observed that she had trouble setting limits for her children, they said that she was always open to feedback.

Likewise, Marie thought of Paula as a model child welfare client because she consistently followed through on case plans. For 18 months, beginning while she was in the drug rehab program, Paula visited Janet each week to attend their family therapy session at Oak Hill. Lacking her own transportation, Paula had to catch a bus and then walk the half mile to the center. Before leaving the drug rehab program, Paula surprised Marie by obtaining a HUD certificate for a three- bedroom house in an upscale neighborhood. Then, she collected used furniture for the new household. Shortly after that, the court reunited one more child with her and the two youngest children. Marie was impressed with Paula’s determination and felt inspired to help her succeed.

Janet Oswalt

At 12 years old, Janet was already 5’5” tall, a large big-boned girl with a freckled complexion. Because Janet was physically mature for her age, child care staff often treated her as an older teen. She had naturally reddish hair, but had bleached and dyed it several colors. Cut in a narrow Mohawk, her hair flopped stiffly to one side of her shaved head. Janet liked to cut her clothing, too, especially skirts and sleeves.

Janet often appeared depressed, alternately sullen or attacking. She felt angry with her grandparents for not taking her back. Janet faulted her mother for her current situation. She didn’t think there was anything in life worth living for: “life sucks” was her stock response. She identified with, even worshipped, singer Kurt Cobain, and the group, Nirvana. She claimed to be a Nazi, spouting white supremacist ideas, without regard for Latinos and African American staff and youth at the residential facility. Even when among peers, she seemed socially isolated and unhappy.

In contrast to her mother, Janet was not doing well at Oak Hill, creating trouble in so many ways that it was hard for staff to keep up with her. Although Janet was bright, she didn’t like school. Often, she would blow up about something and walk out, heading toward the lake and looking for sharp things. School staff would always go after her, creating dramatic chase scenes. Sometimes, she would pick up a paper clip or staple and, back at the center, she would cut herself, usually on her arms. Other times, Janet would stick sharp

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objects into her tongue. But invariably, she also showed someone what she had done. She did not want to be in a residential treatment center—she was angry about that. Center staff suspected that she wanted to go back to the hospital.

During home visits, Janet’s siblings were simply afraid of her. Because she was so emotionally labile, with dramatic mood swings, they never knew when she would sullenly withdraw or lash out indiscriminately. Because several of the younger children were hyperactive, they often antagonized Janet. Even though they were terrified of her, they sometimes poked fun at her clothes and manner.

Caseworkers and Therapists

Janet’s case was among the first assigned to Marie after she began work as a Special Unit foster care worker. Despite all the problems, she was drawn to Janet. As Marie told Luis Medina, her coworker from mental health, “Janet’s really tough on the outside but the sweetest, softest kid underneath that shell.” Marie enjoyed the girl’s colorful style and could usually deal with her anger. But Marie struggled to reach her during the intermittent sullenness and felt frustrated when the girl would withdraw and refuse to talk. One time, for instance, when Marie and Luis took Janet to McDonald’s, she sat on the curb outside and simply refused to go in or to explain why.

Of all the mental health caseworkers with whom she worked, Marie probably enjoyed Luis the most. He was fun, usually taking work more lightly than Marie did. But Luis felt more frustrated with Janet than Marie did. Naturally gregarious and playful, he easily established rapport with clients, especially children. Janet, however, sometimes thwarted even Luis’s efforts to connect with her. In his presence, she would make derogatory remarks about Latinos. But these comments never seemed aimed at Luis personally, as if she excluded him from the category.

At Oak Hill, Janet was assigned to Samantha Myers, a 28-year-old psychologist, with a new Ph.D. Because Samantha’s office was located on the grounds, Janet stopped by to see her almost every day, in addition to their weekly therapy session. From Samantha’s verbal reports, it sounded as though Janet took everything to the young psychologist and opened up with her a great deal. Over time, it came out that Janet didn’t trust her mother to stay sober nor to hold a job and make money and keep a house. Janet didn’t trust her mother to parent the younger kids and was frightened about them being in her care. She feared that Paula would blow it and the family would end up homeless again. Janet was tired of moving from place to place. Although Marie perceived Samantha to be bright and a good therapist, she worried that Samantha was becoming Janet’s only ally. Further, Marie feared that Janet could “pull the wool over” Samantha. Rather like Janet, Samantha was sometimes not very forthcoming, generally giving information only when asked directly. Despite her misgivings, Marie was glad that Samantha had developed this relationship with

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Janet, that someone seemed to be reaching the girl.

Reunification

While Paula was being reunited with the younger children, Janet was not doing better at Oak Hill. Though talking less about suicide, she was still sticking things into her tongue, still walking out of class, still dressing the same. With Marie, Janet remained rather unpredictable. At some sessions she could be fairly talkative while at others she would just sit there, refusing to talk. But she was always negative, looking and sounding as though she felt persecuted and unhappy.

It appeared to Marie that Janet relied primarily on Samantha, not on any other peers or staff, for interaction or individual attention. Based on what Samantha told Marie and Luis, she had more success than anyone else in talking with Janet but generally declined to confront her about problems Paula identified. For example, Samantha reported that during a home visit Janet had yelled at the little kids, telling them the TV was too loud, slammed doors, and then refused to come out of her room. As a result, the family couldn’t follow through on plans for an outing, and the kids had renewed fear of Janet. When Paula mentioned this incident in therapy, Janet countered, “The kids were so loud, and you couldn’t control them. “Besides,” she said, “I didn’t want to go on that outing anyway.” In response, Samantha would usually empathize with Janet, saying, “I know it’s very stressful when you go home, kinda overwhelming.” But it wasn’t clear to Marie that Samantha would take the next step to challenge Janet on how she and her mother were going to work through these problems.

After 15 months at Oak Hill, staff constructed a behavior contract with Janet. The girl wanted out of the center, and Paula wanted her daughter to come home. Marie knew that foster placement was not an option because of Janet’s age and problems. Teen placements were hard enough to secure for kids who had never been suicidal, who were not so difficult. After 3 months, Janet was following through pretty well so staff lobbied for longer home visits. Janet spent 2 weeks with her mother over Easter break. For a couple of months, Paula kept Janet part of each week. Then, at the beginning of the summer vacation, Janet moved home. Paula was terrified to have Janet back but wanted her to come home. She also worried that the longer Janet stayed away from home, the harder it would be to make it work. Paula felt confident that she would not break her sobriety and would not be abusive or neglectful. But Paula was not sure she could provide the in-home supervision Janet needed. In addition, she worried for the physical and emotional safety of the younger children because she didn’t know what Janet would do.

When Janet left the treatment center, she became eligible for outpatient mental health services. Luis was working to arrange for outpatient mental health

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services through the county, though not so urgently as Marie would have done. As a result, the services were not yet in place when Janet moved home. To bridge the gap, under special arrangements, Samantha continued seeing Janet to help her adjust. But because of funding restrictions, everyone knew Samantha’s services could only be temporary.

As the foster care worker, Marie had experienced subtle pressure to reunify this family. Intellectually, Marie was convinced about the importance of achieving permanent plans for children, and was committed to reunification, even when this seemed improbable. In this case, reinforcing Marie’s own desire, her supervisor clearly favored reunifying Janet with the mother and strongly affirmed Marie’s efforts to do so. When Janet fulfilled Oak Hill’s behavioral contract, staff members were ready to move on. Paula was doing very well personally and wanted to have Janet come home. The various attorneys seemed pleased with Marie’s emphasis on reunifying the families rather than merely rescuing children. Because Arizona state law required that child welfare staff have a permanent plan in place within 18 months of placement, the court had affirmed the time frame for reunification.

Reunification, Not

Marie felt disheartened by the disruption after the Burger King incident. She had spent nearly 2 years working up to this point, on a case opened soon after she arrived at the agency. But now, less than a month after returning home, Janet had already moved out. This incident substantially set back the process, even undermined the possibility, of reunifying Janet and her family.

Where do we start, and where do we go from here, Marie wondered silently.