Kathleen W. Jones. Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority. Cambridge, Mass. and London, England: Harvard University Press, 1999. x + 310 pp. $47.50 (cloth), ISBN 978-0-674-86811-3.
Reviewed by Theresa Richardson (Psychological and Social Foundations Department, University of South Florida)
Published on H-Childhood (February, 2000)
Revisiting the Medicalization of Childhood and The Colonization ofChildren's Policy by Psychologists and Psychiatrists
Taming the Troublesome Child, a study of the Judge Baker Guidance Center in Boston, crosses the history of childhood and family with the intellectual and institutional history of psychiatry (p. 3). It is the latest of a series of historical works on twentieth century childhood in the United States as shaped by medical models derived from psychiatric and behavioral science disciplines. This includes Theresa Richardson's study of the development of psychiatry and the mental hygiene (or health) movement's contribution to the scientization of child life movement (p. 232, fn 4), and Margo Horne's extensive study of the child guidance movement. The history of childhood has grown exponentially over the past two decades. At first, as an expansion of the "new" revisionist history of education beginning in the 1960s, the subjects of children, women's roles, family life, related social policies, and professions came under scrutiny. It was perhaps inevitable that these areas eventually collided with the history of psychology and psychiatry especially as historians began to study the early asylums and reformatories associated with the "insane," "mendicant," and "delinquent," which led to studies on the treatment of children described as "feebleminded," "dependent,"and "truant." As social and intellectual history began to relate to the social context of the construction of ideologies, Sol Cohen identified what he called the "medicalization" of education. He argued that a "seamless web" of psycho-biological assumptions frames the fundamental paradigm describing the relationship between children and adults in the twentieth century. The therapeutic model and the professional entourage that makes use of a clinical approach to treating and curing wayward children is no less entrenched today. The Judge Baker Guidance Center, established in 1917, is now called the Judge Baker Children's Center and is still in business.
Jones focuses her study on "child guidance," which is a synonym for mental hygiene (now mental health) clinics and related professionals (p. 2). The twentieth century mental health movement was concerned with preventing abnormal behavior. The movement as expressed in child research was equally concerned with establishing standards for normal development and personality, which resulted in the "invention" of adolescence and, eventually, adolescent psychiatry in the post-World War II era. Child guidance was the aspect of mental hygiene that remediated rather than prevented "bad," or unhealthy behavior in children. It assumed a Freudian psychoanalytic approach where a child's misbehavior was considered to be a symptom of parent-child conflicts. The mother, as the primary care giver, was identified as the source of the problem. Jones uses case file data to try to "get at" (p. 149) the children themselves as "protagonists" in the process of clinical exchange. She adds to the study of childhood by using the case data in order to go beyond the intellectual and institutional history of psychiatric practice.
Jones begins by revisiting the "professional debates over medical theory and therapy" as revealed "in the published literature" (p. 149). She traces the origins of child study and child psychology as it led into the Progressive Era juvenile court and subsequent post-World War I child guidance movement. The first chapter "reconstructs" the origins of the idea of "troublesome" children in the establishment of the first juvenile courts (1899), which were largely concerned with the children of immigrants. Jones looks at the asylum movement (for the insane, feebleminded) and early psychiatry that began to sort populations according to their depend or deviant status; and through the work of the "child savers," charitable middle class reformers. The correlation is not made to the development from the 1830s with parallel child specific institutions in the common school, and juvenile reformatory, nor in the compulsory education, anti-child labor and other legislation that redefined the child's relationship to the state.
In the second chapter, Jones focuses on William Healy and the Juvenile Psychopathic Institute in Chicago. Inexplicably the work of the National Committee on Mental Hygiene, which borrows from Healy's work at the Institute with Augusta Bronner, in shaping its own agenda to promote child study and child guidance, is missing as are all funding agencies throughout the work. In the third chapter, Jones uses the device of studying the "ritual practices" within the clinic to understand the formation of the therapeutic team. The purpose is to "examine the rituals of practice that clarified the work of each profession" that comprised the mental hygiene team of psychologist, psychiatrist, and social worker (p. 15). While it is claimed that this created a "single voice of child guidance" (p. 15), in fact few clinics actually had the full composition of the three member team. Training in psychiatry lagged behind the production of social workers and psychologists. The team and the voice were orchestrated by the large scale funding agents such as the Rockefeller philanthropies, Commonwealth Fund, and others that supported the professionalization of the social sciences. This aspect of the social dynamics of the time provides a considerably more lucid context for the examination of professional rituals as they are played out in the power relationships of clinical practices between experts and patient/clients.
The fourth chapter tries to capture the dissemination of child guidance to the public. The fundamental observation that the focus turned from controlling the children of immigrants and molding them into acceptable "Americans" to the middle classes as a target population is clear from the literature. Jones misses the causation, however, as she attempts to explain the resonance of child guidance popularizers and middle class families on a psychoanalytic level. Part of the program of the philanthropies that funded child research and the child guidance clinics, such as the Laura Spelman Rockefeller Memorial, also participated in funding dissemination agents such as parenting classes, advertising in new magazines such as Parent's Magazine, and later Women's Day, and Family Circle. They additionally supported training programs for professionals at major universities and the publication and regulation of academic literature on children. While in some cases the target was exclusively middle to upper class, the continuing concern with "cultural lag," and the remediation of "wayward" populations through the uplift of children is still a major aspect of the family mental health network today, the contemporary legacy of child guidance and mental hygiene clinics.
In the first five chapters Jones establishes "child guidance as a psychological paradigm that individualized and democratized (or disassociated from a class identity) the troublesome child, that turned common childhood behaviors into symptoms of psychiatric diagnoses, and that established the child's emotional vulnerability as the primary source of problems"(p. 149). The origins of a therapeutic approach to solving children's problems is offered as a background for the more original aspects of her study. In the sixth chapter she turns to the child clients of the Judge Baker Children's Center in Boston, founded in 1917, making the last three chapters (pp.148-228) the most interesting in the study. Jones examines the interdisciplinary team of child guidance as they attempt to make boys into "real men" and girls into "real girls" (pp. 150-1) through sex education, vocational training, psychological testing and therapeutic sessions. Jones essentially psychoanalyzes the case records of sessions among children, parents, and therapists. Quotes from the case records provide a snapshot of children caught in the straitjacket of involuntary therapy. Jones's describes the resistance of children to their therapist and the frustrations of parents and professionals in order to illustrate the fundamental failure of child guidance as a strategy to solve either personal or the social problem of poor parenting. Jones does best in her analysis of the gender-biased therapy and training sessions where girls were encouraged to adopt traditional dependent roles and boys were encouraged to define themselves against other boys, i.e. "who was strongest, who fought best, who was the leader, who looked normal" (pp. 172). The best aspect of this chapter is the description of case files, which has similarities to W. I. Thomas's case studies in the Unadjusted Girl, published out of the Chicago School of Sociology in the 1920s. Thomas's insightful analysis was more profound, however, in his famous observation that: "What men take to be real is real in its consequences."
In the seventh chapter Jones illustrates how emergent professionals in psychiatry, psychology, and social work came to vilify mothers for the "troublesome" behavior of their children. Jones's interest in gender, even as she skirts class and race, provides insight into the way that fundamentally patriarchal institutions disempower women and children. The concentration on sexuality and Freudian approaches to psychotherapy became directed toward the "pathological mother" (p. 173). This chapter explores the thesis of professionals that "sick" children are caused by "sick" mothers. The Judge Baker Foundation, which supported the clinic along with the Rockefeller Foundation, in 1943 extended this work to infants and preschool children in time for the post-War baby boom.
Jones, in the effort to diagnose a psychological profile of the experience of troublesome children, fails to take social dynamics into account, that is the political, economic, and social climate as ordered by social class, race, and ethnicity. She concedes her bias that "to build the story of child guidance as a tale of scientific progress in a broadly defined field of child psychology is a scaffolding difficult to reject" (p. 4). Causation becomes a general aspect of the inevitability of progressive change itself, supposedly revealed in the emergence and dominance of the therapeutic model over time. Nonetheless, she also critiques this view in that it "divorces the cognitive structure of child guidance from the social context in which a psychological understanding of troublesome children developed" (p. 4). The causation in this case becomes individualized rather than social or historical. Her use of psychoanalytic and psychological forces to explain context omits the very history she is trying to capture. Jones's use of a psycho-historical approach to analyzing the record results in a whiggish history that fails to make the connection between biography, either individual or institutional, and social structural issues of the politics of power and dominance over time. The critique of psychiatry becomes a crisis of authority, and the story the failure of therapeutic methods to achieve cures among its patient-clients, who are mysteriously "caught in the middle." The survival of child guidance, now mental health clinics, is attributed to their ability to adapt. The ability of institutions to adapt also has a lot to do with funding and support. The longevity of professional psychologized paradigms is also intimately connected with the correlation of individualistic, "democratic" (Jones's word for the disassociation of class, race or ethnicity as factors in determining pathology or normality) approaches to problem solving as serving the interests of a professional elite and their mentors.
This book is, nonetheless, recommended for its gender analysis of the clinical practices used in therapy and the process whereby mothers were selected as the focus of therapeutic intervention. The case data from the Judge Baker Guidance Center indicates a productive source of information on children's experiences in the twentieth century. Clearly, scholarship on the subject of the intersection of medicalized knowledge and the behavioral social sciences in relation to children is far from being complete.
. Theresa Richardson, The Century of the Child: The Mental Hygiene Movement and Children's Policy in the United States and Canada (Albany, N.Y.: State University of New York Press, 1989); and Margo Horne, Before It's Too Late: The Child Guidance Movement in the United States, 1922-1945 (Philadelphia, Penn.: Temple University Press, 1989). See the review by Sol Cohen, "The Triumph of the Therapeutic," History of Education Quarterly Vol. 30, No 3 (Fall 1990), pp. 371-379. There is also an in-house history by Pamela A. Holcomb, The Pittsburgh Child Guidance Center, 1931-1981: Fifty Years of Leadership in Children's Mental Health Service (Pittsburgh: Pittsburgh Child Guidance Center, 1985).
. David J. Rothman, Conscience and Convenience: The Asylum and its Alternatives in Progressive America (Boston: Little Brown and Co., 1980); Linda Gordon, Heroes of Their Own Lives: The Politics and History of Family Violence, Boston, 1880-1960 (New York: Viking Penguin, 1988); Peter C. Holloran, Boston's Wayward Children: Social Services for Homeless Children, 1830-1930 (Rutherford, N.J.: Fairleigh Dickinson University Press, 1989); Eric C. Schneider, In the Web of Class: Delinquents and Reformers in Boston, 1810-1930 (New York: New York University Press, 1992); and Joseph M.Hawes, Children Between the Wars: American Childhood, 1920-1940 (New York: Twayne Publishers, 1997).
. Sol Cohen, "The Mental Hygiene Movement, the Commonwealth fund and Public Education, 1921-1933," in Gerald Benjamin, ed. Private Philanthropy: Proceedings of the Rockefeller Archive Center Conference, June 1979 ed. (Tarrytown (now Sleepy Hollow, New York: Rockefeller Archive Center Publication 1980); Sol Cohen, "The School and Personality Development: Intellectual History," in John Best, ed. Historical Inquiry in Education: A Research Agenda (Washington, D. C.: A.E.R.A., 1983, pp. 109-1933; Sol Cohen, "The Triumph of the Therapeutic," History of Education Quarterly 30, (1990); See: Sol Cohen, Challenging Orthodoxies: Toward a New Cultural History of Education (New York, Washington, D.C./Baltimore, Boston, Bern, Frankfurt am Main, Berlin, Vienna, Paris: Peter Lang, 1999).
. Heather Munro Prescott, A Doctor of Their Own: A History of Adolescent Medicine (Cambridge, Mass.: Harvard University Press, 1998); Richardson, Century of the Child_.
. W. I. Thomas, The Unadjusted Girl: With Case Studies for Behavioral Analysis (Boston: Little & Brown Company, 1923).
. See Theresa Richardson and Donald Fisher, eds., The Development of the Social Sciences in the United States and Canada: The Role of Philanthropy_ (Stamford Conn..: Ablex Publishers Inc., 1999), see the chapters by James Capshew and Judy Sealander.
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