Some notes about theory and practice in work with children in residential child care

By Hans Kornerup

Date Posted: Saturday, 4 June 2011

Hans Kornerup is a licensed psychologist and specialist and supervisor in child psychology and psychotherapy. From 1979 to 2009 Hans was the Director of Nebs Møllegard a therapeutic community for young people situated in Copenhagen.

Hans edited “Milieu- therapy with children”, which was published in Denmark by Forlaget Perikon in 2009. The English language edition is distributed in the United Kingdom by the National Children’s Bureau. “Milieu-therapy with children” is a seminal text which helpfully builds a bridge between the psychodynamic therapeutic community approach to residential child care and that of social pedagogy.


Some notes about theory and practice in work with children in residential care


To any question the answer is given; meaning that the answer(s) to the question are implicit in the question and so the answer(s) are in that sense given.

Therefore it is essential to put up questions of relevance to prevent limited and impracticable understanding and solutions to problems we want to act upon, unless you are very aware of this and make an analysis of the question.

When I read the announcement of the one day seminar at the Tavistock Institute in October 2010 with the explicit main theme “Putting Theory Into Practice” a bell rang at once. In all my 40 years in working with unintegrated children and in my meeting with social pedagogues and milieu-therapists I have been confronted with that issue and always I have tried first of all to point out:

1. Theory is nothing less than systematic conceptualized practice experience

In my view, the fundamental problems don’t occur in the process from theory to practice, but when people working directly with children get their own experiences, and in that way this is categorized and remembered, in other words, going from practice to theory. This, in exactly the same way as the natural process of the child’s inborn capacity for reality testing, is meant to create a good sense of outer reality and of oneself which then creates a new base for further exploration and action. The theme for the Tavistock conference could in this way likely have been announced: “How do we learn from the experiences of other people?”

Of course, I recognize and value the possibility to learn of other’s experiences (for example from their formulated theory), but this must always be grounded in a genuine wish and aim to search for more knowledge and understanding which is an expression of advanced reality testing and curiosity. This process cannot be forced, neither concerning the child nor the development of the grown-up professional dealing with the unintegrated child. What comes to mind as an example of this is when one has – perhaps prematurely – read a book of theory , and then rereading it several years later, the feeling arises, “this is not the same book, it is a new one.”

What our field needs is to keep up, and to stress is the possibility and the value of good practice characterized by making new experiences (and creating new theory) and searching for knowledge in existing theory. (It is not necessary to reinvent the wheel every time). The starting point is practice and what we already have in our luggage. The rest is subordinated.

But this approach contains also some other difficulties. First, there is among practitioners some reluctance to thinking on these lines. Bion in his late Tavistock days pointed out there may always be others, of especially outstanding capacities, who will have contributed much more important findings than those we have to contribute. In contrast to this, I have come to the conclusion, when I observe my colleagues in the field of clinical psychology, that they seem to draw some hasty personal conclusions from their valid experience. For example if there is a coincidence, something happening more than once (i.e. twice) they see this as a tendency. The third time they have a law of regularity !

In addition to all this, there exists another problem; the imminent resistance of the idea of theory. The above mentioned conference theme “From Theory to Practice” tends to stimulate an idea among social pedagogues, that theory is superior to practice. My view is that this underestimates and undermines the social pedagogue’s conception of their own skills, but then it may seem to them that the latter position suggests that theory is something rather abstract and useless. My attitudes to this have always been to stress the consequences of statement 1 and then quote Kurt Lewin saying:

2. There is nothing more practical than good theory

Another misunderstanding among social pedagogues (and others) is the belief that theories either are true or false, are either right or wrong. This conception leads to some unconstructive and unfruitful activities, because:

3. Theory is not true or false, theory can only be relatively good or bad

What decides the quality of the theory is, to which extent the theory helps us to understand the phenomenon we try to act upon. This implies when it comes to action:

4. It is the understanding of a given problem that determines the theory (and then the method)

For people in the field who are working with children, an immediate double challenge arises. First, the capacity to analyse a given problem. Second, how to acquire experiences in relation to the first, – which theories can be helpful to bring us further to solve a concrete problem and facilitate development for the child?

Let me illustrate and compress these 4 statements with an example from daily life:

If even in old age I still want to seduce my wife suggesting “going to the beach to look at the sundown”. In that case I have applied the theory of naive realism, and maybe I succeed, trusting that the world is like I see it. I would hardly say: “Darling, shall we go to the beach to look at the earth turning ?” The use of facts of natural science will then properly fail in this case. If I was going to the moon instead, rather than being engaged in the act of romantic seduction, this approach would surely be a good idea instead of a naive realistic approach, as we do know something about the work of Kopernikus and the laws of Kepler and Newton.
From these reflections follow, particularly in accordance to statement 3 and 4:

5. The choice of theory has to be selective

This is because there is not only one conclusive theory of the human mind and its development.
To deal with several difficulties in understanding, caring and handling the child it is important:

6. To be familiar with different kinds of theories

At this point the theme from the Tavistock conference is of great relevance and a challenge too. Going from theory to practice implies that you have knowledge of theory, and how it is constructed and established. In my understanding as mentioned above, this learning process must be closely linked to the motivation for learning about theory relevant for the given primary task. Without foundation in practice, theory is an abstraction and thus making it very difficult to transform theory to practice.

7. To be familiar with different kinds of methods

This follows naturally from statement 6, but also helps to avoid the situation of the carpenter whose only tool is a hammer. If so, he has a very limited possibility of fulfilling his multifaceted job and he may have a tendency to solve all his professional problems with nails.

8. To anchor the work in theory

In accordance to statement 1 this implies, that we should not behave unprofessionally in work with children, unprofessional in the sense of by accident, but professionally i.e. based upon experiences and theory.

9. In work with children in residential care, theory must be selected among different kinds of developmental psychological theories

The superior primary mental task for children is to achieve “natural” development. But which kind of developmental theories in the work with children in residential care are then empirically relevant? To elucidate this question, we have to at least be specific on the task and of the child’s inner personal construct. If we are dealing with an integrated child with a good inner “object constancy”, he or she should be met with normal age-appropriated expectation and psychological knowledge from normal development socially, intellectually and emotionally. This will then represent a good enough and appropriate stimulation for this child’s further development. When we are dealing with emotionally disturbed and unintegrated children, in the need of treatment, the above approach will be insufficient at best, at worst directly damaging. Something more advanced in experiences, understanding and theory is then needed. Here the works of Freud, Bowlby, Klein, Winnicott and Stern for instance may be helpful.


Michael Helge Rønnestad comments,

This article is obviously written by someone with a combination of high-level epistemological knowledge and clinical experience. A joy to read.