The successful family reintegration of street-connected children: application of attachment and trauma theory
| DOI | https://doi.org/10.1108/JCS-09-2015-0028 |
| Published date | 19 September 2016 |
| Pages | 217-232 |
| Date | 19 September 2016 |
| Author | Anita Schrader-McMillan,Elsa Herrera |
| Subject Matter | Health & social care,Vulnerable groups,Children's services,Sociology,Sociology of the family,Children/youth,Parents,Education,Early childhood education,Home culture,Social/physical development |
The successful family reintegration of
street-connected children: application
of attachment and trauma theory
Anita Schrader-McMillan and Elsa Herrera
Anita Schrader-McMillan is a
Senior Research Fellow at the
Medical School, University of
Warwick, Coventry, UK.
Elsa Herrera is based at
JUCONI Foundation,
Puebla, Mexico.
Abstract
Purpose –The purpose of this paper is to identify elements of success in the family reintegration
of children with street connections who have experienced chronic violence and loss in the context
of poverty. This paper outl ines the application of com plex trauma theory into a pr actice model
developed by the JUCONI Fo undation in Puebla, Mexi co to help children and fam ilies prepare and
manage reintegration .
Design/methodology/approach –This is a 15-month qualitative study involving semi- structured
interviews with families and boys at three stages: preparing for return, in the first three months of
reintegration and successfully reintegrated. The study comprises interviews with frontline workers and
focus group discussio ns with the project team. In addition, six yo uths who did not return to their families
were interviewed.
Findings –The study focuseson an attachment and trauma-basedapproach to family reintegrationof street-
connected childrenoutside parental care. The findings highlight the needfor careful preparation of both child
and families (including siblings/extended family) priorto reunification. Preparation needsto focus on resolving
the underlyingproblems that haveled to the child being on the street and “phased”reintegration(beginning with
visits to the family) is recommended. Follow-up visits/family workby staff are usually essential to ensure that
child/youthand family adjust to each other.The theoretical frameworkand rationale behind the useof the tools
and strategies described needs to be understood, so that they are usedintentionally and consistently.
Research limitations/implications –The study cohort involved only boys and other factors are likely to
affect the reintegration of girls. The study took place in Mexico only and methods used by JUCONI need to be
tested in other contexts.
Practical implications –The integration of children without parental care into families is an issue of critical
interest, but thereis currently very limited research or guidanceon reintegration of children who have lived on
the street, especially in low and middle income countries. The study should be of interest to practitioners
interested in assessing whether safe and sustainable reintegration is possible and facilitating this. The paper
may be of interest to practitioners working with children growing up without parental care who do not have
“street connections”, but who have experienced chronic violence and loss.
Originality/value –This is the first study to describe the application of an attachment and trauma
perspective to work with children who have lived on the street.
Keywords Complex trauma, Child abuse, Neglect, Emotion regulation, Children without parental care,
Family reintegration, Street children
Paper type Case study
Introduction
The term street childr en, while still highly c ontested, is general ly applied to children f or whom
“the street”(inclu ding unoccupied dw ellings, parks and w asteland) has become home and/or
their source of livelihood, and who are inadequately protected or supervised. While in the
Received 9 September 2015
Revised 21 January 2016
Accepted 6 July 2016
Conflicts of interest: the second
author is employed by the JUCONI
Foundation. Help in kind was
provided by the JUCONI
Foundation to reduce costs
of the study.
This study was funded by Family
for Every Child. The authors thank
all children, families and workers
involved with this project, and
Professor Jane Barlow,
Emily Delap, Hugh Salmon and
Dr Sarah Thomas de Benitez for
reading drafts of this paper.
Above all, The authors thank the
late Alison Lane OBE, CEO of
JUCONI. She died all too young
and is greatly missed.
DOI 10.1108/JCS-09-2015-0028 VOL. 11 NO. 3 2016, pp. 217-232, © Emerald Group Publishing Limited, ISSN 1746-6660
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1980s a clear distin ction was made between child ren who lived almost entir ely on the street and
had little or no conta ct with their famili es and those who work ed on the street but “lived”
with families, ethn ographic studies ov er two decades have show n that these categorie s
are far from watertig ht and that children ’s experiences var y enormously over ti me and place
(Thomas de Benitez, 2011). However, what is consistent in reviews of the literature on
street-connected children is their high level of exposure to violence, from families, adults on the
street, including police and security services, and other children (see review level evidence
in Thomas de Benitez, 2007). A small number of organisations working with street
children –or children with “street connections –are therefore inte ntionally integrating strate gies
that can help youngsters recover from the impact of violence and develop resilience in
violent environm ents.
Since severe and ch ronic violence, p articularly when it begins e arly and stems from a primary
carer, can compromise the social, emotional and even physical trajectory of human
development, it is important for organisations that work with street children to have an
understanding of h ow this will affect the ir practice. Stu dies involving chil dren from a range of
highly disadvantaged backgrounds (children in war zones, chronic poverty, with a parent in
prison, etc.) show that their capacity to do well in these contexts depends to a great extent on
the security they feel in their family unit; an emotional security that also increases children’s
capacity for cogn itive gains, espec ially as access to s chool is an additiona l protective fac tor
(Newman and Blackburn, 2002). In contrast, accumulating evidence shows the effect of
exposure to violence ( even witnessing vio lence) in childhood on c hildren’s brain development,
mental health probl ems, physical health and social cap ital in later life (Repetti et al.,2002;Anda
et al., 2006). Children exposed to cumulative and chronic victimisation –polyvictimisation –face
far higher cumulat ive scores on measure s of psychological di stress, including anxiety and
depression, ange r and post-traumatic stress disorder (PTSD) (Fi nkelhor et al., 2011; Moffitt and
The Klaus-Grawe Think Tank, 2013). For boys, witnessing domestic violence leads to of
increased risk of in ternalising and ext ernalising behavioural problems, PTSD, depression and
anxiety, perpetrating and/or being a victim of bullying, decreased sense of self-worth, self-
blame, cognitive i mpairments, redu ced school performa nce and health probl ems through
childhood and beyo nd (Evans et al., 2008). Loss of impulse control and identification with the
perpetrator increase the risk of violence perpetration on their own partners. One reason for this
is that exposure to actual or perceived danger generates the release of stress hormones in the
cerebral cortex; when children are in this state, the development of other functions of the brain
(cognition, affe ct regulation) are c ompromised (Luec ken and Lemery, 2004) . The effects of
violence are most marked when it begins in infancy (the phase of most rapid brain development)
and when it stems fro m a primary carer, sin ce this is a direct as sault on children’s capacity to
form a secure attachment (Main and Hesse, 1990; Howe et al., 1999).
This does not mean that all street-connected children have been traumatised and/or have
insecure or disorganised attachment patterns, but that they may have. Family reintegration of
children exposed to chronic violence and/or neglect (particularly from infancy) therefore
presents challenges that are different from those of other children growing up without
parental care but not necessarily exposed to violence (see Mann, 2014). Preparation and
follow-on are essential in order to ensure that the family and child are both ready for this and
that positive gains are made and can be sustained.
Until recently, ho wever, few organis ations working wit h street children in t he region (or
anywhere) have also worked systematically with children’s families. In Lati n America residential
care in institutions (CCIs) is still the default option for children who have no parental care or who
are deemed to be at risk of h arm, in spite of robus t evidence about the adv erse effects of this
policy (particularly long-term placement of young children in large establishments (Czaky, 2009;
Nelson et al., 2009; Tarullo et al., 2007). But efforts by non-governmental organisations (NGOs)
and others to reduce institutional care can result in children being forced back to families
that do not want them or from which they have fled in the first place (see e.g. Lam and
Cheng, 2008) –a grave violation of children’s rights. There is a powerful argument to assess
and work with famil ies in order to ensure that these fa milies become safe and nurturin g while at
thesametimeworkingwiththechildren.
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