Max often gets angry. But not so often and for so long anymore. “We have been helped enormously in how to deal with him,” says his mother, Paula van den Akker. She sits on the couch with her husband Bastiaan in their house in Almere. Max (11) has just made coffee and left for his room. Next to the couple is Vanessa Leerdam, behavioral expert of a team that managed to get the family out of misery thanks to a new youth care method. Without Max being removed from the home.
From the age of five, Max started having “angry moods,” his parents say. These sometimes lasted a whole day, and he could not calm down. Bastiaan (52): “He gets angry when he doesn’t feel understood. At school he often had to walk on his toes, he was also often bullied. During angry moods he usually stomps his feet upstairs and starts swearing. Recently he calms down quite quickly.”
The police pushed him to the ground with four men. They carried him into the station and held him in a chair with three men
Paula (43): “He was very aggressive. He often hurt me. He kept running away. Did strange things. In my presence he would walk to the bus lane and stand still there. I had to pull him away when the bus came. They were serious incidents. And last November it got out of hand. Then he stood on the bridge behind the police station and wanted to jump into the water.”
Truck driver Bastiaan: “I received several calls while driving that my son was standing in the bus lane and wanted to commit suicide. And then this happened.” Paula: “The police pushed him to the ground with four men. They carried him into the station and held him in a chair with three men.”
‘Through the fire for our children’
The incident with the police was one of the moments when Bastiaan and Paula thought that Max, Chris’s young brother (14), might be better off being removed from the home. Paula: “We have always said that we did not want that. Because of what my husband has experienced.” Bastiaan: “I was also removed from home. My parents had alcohol problems. They were in bed or in the pub. We were left to our own devices.” Paula: “We will go through any pain for our children. But it became so intense. Our backs were against the wall. Our eldest suffered from it. I was a mother of two, but I was only there for one. We were really going through it.”
Son Max .
photo Saskia van den Boom)
According to the family, the fact that Max still lives at home and that peace has somewhat returned and that his parents have not decided to separate – as they once intended – is due to a team of experts from the Youth Care Region Flevoland. This was set up four years ago and has a new, unorthodox approach. Youth care workers, psychologists and behavioral experts work in a permanent team to immediately assist families in acute need. Without a waiting list, almost as fast as the fire brigade.
Behavioral expert Vanessa Leerdam: “We received a call from the psychologist who already knew Max: whether we could prevent an out-of-home placement. We immediately consulted from various disciplines. We not only look at the behavior of the child, but also at the parents. We deployed a family counselor and a social psychiatric nurse.”
That worked. Paula: “A care worker came to our home every week. He gave tips and tricks, tools; we did a role play. And we learned to talk to Max differently. Asking short questions, for example. Not: how was it at school? But: what were you going to do when you entered the school?”
Bastiaan: “He has changed a lot. He is actually doing very well.” Paula: “We also talked to his brother and explained what was going on with Max. They argue much less. We haven’t laughed in the family for a long time. Now we do again.”
Fear of ‘insecurity’
The expert team in Flevoland uses an ‘acceleration approach’ that was set up four years ago, at the request of the region, by public administration expert and ‘change agent’ Nienke van de Hoef, together with psychiatric nurse and care manager Marjolein Duin. They say that youth care should change into family care: too often the attention is focused only on the child.
Van de Hoef gives the example of the child of a divorced truck driver who was often away from home. The child began to experiment with drugs, walked like thrill seeker along the track and was immediately considered a problem. “But we asked that father if he could stop international trips, so that he could sit at the table with his son every evening.”
In youth care, sometimes someone from the training comes, knows nothing and then has to organize everything in a family on his own.
Out of fear of “insecurity” within families, but especially out of fear of mistakes that could potentially lead to family drama – with all the media attention that entails – youth care workers tend to immediately place children elsewhere, say the change agents. “While an out-of-home placement is extremely harmful for both parents and children. The cure is often worse than the disease.”
Youth care workers, who often operate alone, do not always dare to talk to a parent. Van de Hoef: “I worked for the police, where they go out in pairs and discuss how they approach an arrest, for example. And after an incident they discuss what went well and what went less well. In youth care, sometimes someone from the training comes, knows nothing about anything and then has to organize things in a family on his own.”
‘Burning coals are left lying around’
And even as an experienced youth care worker, it is sometimes difficult to provide care, says Duin. “You come into a turbulent environment with sometimes up to ten family members, all with their own dynamics. It is then difficult to keep an overview and find the right tone. In such a situation, do you dare to speak to a severely addicted parent alone? Do you dare to talk about whether that addiction is burdening the child? And whether that parent is willing to be treated?” Avoidance then lurks. Van de Hoef: “Out-of-home placement is then seen as a safe alternative.” Duin: “That way you fight the fire, but the burning coals remain.”
So it is better to go to a family together and consult regularly, however briefly, with different professionals. And thereby test your own perspective against that of others. Van de Hoef: “Everyone has their own prejudices. We may find it special that a child is hit with a slipper. In other cultures this is very normal. And what do we find worse: a hit or an out-of-home placement, where the child is even more unsafe?”
The new working method has already prevented dozens of out-of-home placements in the past three years, and has also saved a lot of costs. Van de Hoef: “A child who is removed from home costs about a hundred thousand euros per year. What can you do for a family with that money? Treat an addiction. A Portakabin [een prefab huisje] place in the garden, so that an autistic boy can retreat close to his mother.”
Son Max.
photo Saskia van den Boom)
Petition for The Hague
The ‘acceleration approach’ from Flevoland can prevent the number of voluntary out-of-home placements enforced by the juvenile court. That is desperately needed, according to Het Vergeten Kind, a foundation that organized a petition has started to convince politicians in The Hague that a new, national approach is necessary. “With a minister for Youth and Family,” says director Margot Ende.
More than 41,000 children do not live at home in the Netherlands and several thousand children are removed from their homes every year. “A disruptive event,” says Ende. “If a child does not immediately end up in the right place, he or she is transferred an average of six times. The bond with the parents is broken. The child often has to go to a new school. All this causes stress, loss of trust in others and affects self-image, because as a child you think: there are problems, I am being taken away, so it must be my fault.”
When I first came here, Paula was extremely gloomy. And now I see her smiling again. That’s nice
The number of out-of-home placements is “hardly decreasing”, according to a report published on Thursday research of the Verwey-Jonker Institute, commissioned by Het Vergeten Kind. “And this despite the broad consensus that they should only be used as a last resort.” According to the researchers, the cause is not a lack of knowledge or effective interventions, but “the inability to apply them structurally.” Ende: “Many people think of sexual abuse or mistreatment when they think of reasons for out-of-home placement. Yet it usually concerns behavior, psychological problems or upbringing. In those cases, out-of-home placement is often a means of powerlessness.”
Ende sees the “fragmented” organization as the main reason for this powerlessness: “Families often have several problems. no time you have a lot of care providers from all kinds of agencies on the floor, all of whom tackle the problems with their own perspective. That doesn’t add up. I recently spoke to a seventeen-year-old boy. He said that he received therapy to convert negative thoughts into positive ones. That’s difficult when you come home to chaos every day, and nothing is done about the problems there. That is treating the symptoms.”
Behavioral expert Vanessa Leerdam with Max’s parents.
photo Saskia van den Boom)
Complimented
Max’s parents have hope again and live “day by day”. Max was in an angry mood last week. Paula: “A boy at school said he was going to rape his mother.” Bastiaan: “The k-word was also mentioned.” Paula: “He didn’t like that.” Bastiaan: “Max pushed that boy into the bushes and started pounding into him.” Paula: “I told him that everyone sometimes says something that you later regret. And then Max went back to school. He would never have done that before. They were both punished. He took it well.”
Behavioral expert Vanessa Leerdam: “When I first came here, Paula was very gloomy. And now I see her smiling again. That’s nice.”
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