In-Home Counseling Finds Place in O.C. Households : Social work: Helpers teach by example in the kitchens and family rooms of troubled parents.

When Clete Menke knocks, families are liable to yell, “Come on in, Clete!” The kids swarm over him, telling him their news.

In one evening, Menke, a new breed of in-home counselor, will play on the floor with children of a depressed single mother so she can cook their dinner; he will offer strategy in the living room of a middle-class couple as their children race around complaining and their runaway daughter sobs in a chair.

He has answered a beeper at 11 p.m. to go to the home of a suicidal mother and beg her to seek counseling.

He does it because he believes that there’s no place like home--even for children on the brink of being removed by the courts. “Even the most marginal family environment is better than the best foster home,” Menke says. “If we’re going to make progress on this front, we’ve got to fix the family, not the kids.”

In a society that at any given time has half a million children living apart from their parents, it’s a somewhat revolutionary idea. But as social service demands rise and resources fall, it is catching fire.

Under a growing national movement known as “family preservation,” in-home counselors like Menke are spending 15 to 40 hours a week inside troubled homes to demonstrate the most elemental aspects of parenting--cleaning, shopping, feeding, setting bedtimes, even smiling and having eye contact with babies. They also try to teach parents more sophisticated behavior, such as anger control, rational problem solving, goal setting and decision making.

Known variously as “family consultants,” “family connection workers” or “teaching demonstrating homemakers,” the counselors teach by example in the trenches of family life: the kitchens and living rooms of some of the most troubled parents. They hope to improve family life enough so that children are not seriously abused, and so society can avoid emotional and financial costs of needlessly placing children in foster homes, group homes or institutions.

“We’re not going to turn them into Ward and June Cleaver,” says Mike Riley, site director for the Anaheim-based Boys Town branch, one of the home-based service providers to Orange County. “We make them into better parents.”

Sociologists say family preservation represents a “triage” approach to a crisis in child welfare as well as a swing in philosophy, away from judging and punishing “bad parents” and toward understanding and helping them improve “bad behavior.”

It aims to fill a “glaring service gap” between the extremes of doing nothing and removing children from their homes, said Peter Forsythe, vice president and director of children’s programs for the Edna McConnell Clark Foundation in New York, which grants $4 million annually to family preservation programs. “We’re interested in balancing the system so judges and workers and families have a more sensible and effective array of choices,” he said. At best, he said, such programs could reach 30% of those now placed in out-of-home care.

At least 10 states are now aggressively pursuing intensive in-home services, patterned after Homebuilders, a pioneer family preservation program begun in 1974 in Tacoma, Wash., Forsythe said. Last year, he estimated, 6,000 families received Homebuilder-type services in the United States--some state-mandated with hefty budgets, others provided by private agencies. Until recently, California--which along with New York accounts for 40% of all the children in out-of-home placements nationally--has been slow to pursue intensive in-home services, he said.

“I think you will find us making efforts to do even more along those lines in California,” said Maureen di Marco, state secretary of child development and education. “It is far better for us to spend money on the front end rather than wait and have long-term consequences in human terms and financial terms.”

However, she cautioned that efforts to help families must be pursued in concert with other fundamental issues such as the economy, health care, schools and child support payments. Without those improvements, she said, in-house therapy is like “shoveling an avalanche with a teaspoon.”

Whether the programs work is a matter of ongoing research, but “there is evidence you can prevent removal of kids if you intervene powerfully at the time of crisis,” said James Garbarino, president of the Erikson Institute for Advanced Study in Child Development in Chicago. Other studies have shown that family preservation programs increase family functioning at a rate four to five times greater than with traditional office counseling approaches.

The concept leaves some traditional social workers uneasy--particularly in cases of prior abuse. The best candidates for family preservation programs are neglect cases, said Stephen Fox, director of government relations for the Los Angeles County Department of Children’s Services. Sexual abuse cases are not referred, nor are many major physical abuse or abandonment cases, he said.

The risk is that some day a mistake in judgment could be fatal, and “you won’t know until the child is dead,” Garbarino said.

“Statistically, you’re going to make errors no matter what you do,” Garbarino said. “It’s a question of which kind of errors people are willing to live with.”

The growth of family preservation programs indicates an emerging realization that there is no perfect solution for the rising number of reports of abused and neglected children.

In California, the incidence of infants removed from their parents more than doubled from 1985 to 1989, and the number of children in out-of-home care rose 65% to 80,000. According to Children Now, a nonpartisan child advocacy organization, Californians are paying almost $1 billion now to care for these children, a figure that may double over the next four years without corrective action. Los Angeles County alone accounts for 32,000 children in out-of-home care. According to the U.S. Census, Orange County has 19,000 children living with non-relatives, in group homes or institutions.

According to the Center for the Study of Social Policy in Washington, the national crisis in child welfare has resulted from two trends: the rising standards for acceptable parent behavior and the proliferation of impoverished, single-parent or dual-earner families who sometimes find even basic functioning a challenge.

While some blame parental drug use or the decline of family values, others also point to California’s state-funded placement system, which has encouraged counties to order children removed rather than pay for preventive counseling services. After Proposition 13, the state agreed to pay for out-of-home services, while counties were to fund in-home services, Forsythe said. Local decision makers tended to favor out-of-home placement because it was cheaper, he said.

Without in-home services, more children will wind up in a succession of foster homes which remain limited in number and quality and are increasingly viewed as being as risky as the children’s original homes. According to Forsythe, for every 1,000 children in foster care, 30 are abused. “Placing kids always hurts,” he said. “It disrupts their life and raises questions about their sense of identity.”

The reality is, “there is a tremendous number of kids at risk whether we leave them in the family or take them out,” Garbarino said. “It’s not like we have the option of putting them into well-functioning, new situations.”

A new bill, passed this fall, will allow California counties to redeploy foster care dollars to finance family preservation services. The bill also allows three demonstration projects to continue in Alameda, Solano and Napa counties.

Contra Costa County funds family preservation services with help from the social services, mental health and probation departments.

Los Angeles County has seven family preservation projects, some tailored by and for Spanish-speaking or black families.

Orange County’s in-home counseling programs are part of a larger “family maintenance” program and are provided by private groups: Children’s Bureau and Boys Town.

The Boys Town program, which began four months ago in Orange County, is a Homebuilders-type program with added emphasis on parent training. Menke, who holds a master’s degree in counseling, is one of only two Boys Town family consultants. He is booked up through April.

At any one time, Clete Menke will see no more than three families who are referred by county social workers. In contrast, Los Angeles County social workers reportedly carry a caseload of 60 to 90 families at a time. In Orange County, the caseloads are reportedly lower, about 30.

Most parents are under threat of losing their children unless they cooperate, and many are hostile at the beginning of the six- to eight-week intervention. At the end, Menke said some are so grateful they have asked him to move in with them, only half-jokingly.

During the first two weeks, he does whatever is needed to build a relationship with the family. He listens and offers help. If family members play in the park, he plays in the park. If they use four-letter words, he uses four-letter words. “I don’t want them to think I’m an ivory-tower therapist, telling them how to fix their kids.”

Then, during a visit, he might go to the kitchen and do dishes, saying, “You know, it’s a really good idea to do the dishes after each meal.” For one woman who was mending her daughter’s scrapes with toilet paper and Scotch tape, the consultant brought peroxide and Band-Aids.

He explains how good-behavior charts and timeout are more effective discipline techniques than spanking or hitting.

One mother said her children were out of control when she called and asked for a counselor. Two of them had been admitted to psychiatric hospitals, but the doctors there gave her no plan after discharge and now barely remember them, she said.

“Clete can see how everyone interacts,” she said. “He suggested things I never even thought of. I work full time. When I get home, I usually just think, ‘Go to your room,’ I’m so tired.”

Elisa Rios, 26, a Buena Park mother in a drug rehabilitation program, said her experience with judgmental social service workers made her skeptical of the Children’s Bureau family connection worker who came to her home. “She keeps an open mind. I feel the social worker sees the bad stuff and keeps on wanting to see it. . . .

“At the beginning, she’d bring games over. Me and my boyfriend were like, ‘Oh, God, we’re not going to play games.’ Once we got into playing it, it felt like one big happy family.”

Rios said she grew up with two siblings and a single mother who was always working. “I never got to feel that real family feeling. For once, it was something normal, or something simple. To me, it felt good.”

She said she and her boyfriend have learned to argue after the children are asleep. She said she has learned what a goal is and how to think about getting training for a job.

Menke says that whenever he leaves a home, he always asks himself if the children are safe. He is mandated to report abuse, and in one case, he reported a stepfather who beat his stepdaughter.

But he remains an optimist.

“Ultimately, I don’t know if this is the answer,” he said. “But it’s worth a try.”

Number of Children in Foster Care Rises

In Orange County, children up to age 4 in foster care increases 112% from June, 1985 to June, 1989. In California, children in the same age group increased 165% from 1985 to 1989.

Children placed permanently outside of their homes

County: Increase of 33% (1,146 vs. 1,525) from Jan., 1985, to Dec., 1989.

State: Increase of 148% in the last five years.

Rising number of children in group homes

County 130% increase from 213 in 1985 to 491 in 1989.

State: 58% increase

Average yearly cost of a group home placement

County: Increased 70% from $17,392 to $29,520

State: Increased 43.5% to $31,000

Reasons for entering foster care

County: Parental neglect or caretaker absence/incapacity accounts for 61% of cases. About 50% to 60% of children enter system because of family drug or alcohol problems.

State: Parental neglect or caretaker absence/incapacity accounts for 70% of cases. Approximately 65% to 70% of children entering the system do so, in part because of family drug or alcohol problems.

Source: County Welfare Directors Assn.