Child guidance in the United States began with an idealistic mission characteristic of Progressive reform: prevention, first of juvenile DELINQUENCY and then of MENTAL ILLNESS by identifying the first signs of problems in children. Over the years, the goal of prevention faded, and child guidance came to treat mild behavior and emotional problems in children. The child guidance movement began in 1922 as part of a program sponsored by a private foundation, the Commonwealth Fund's Program for the Prevention of Juvenile Delinquency. The movement established community facilities, called child guidance clinics, for treating so-called maladjusted children, school-aged children of normal intelligence exhibiting slight behavior or psychological problems.
The Program for the Prevention of Juvenile Delinquency introduced eight demonstration clinics in cities across the country, which sparked the creation of some forty-two clinics by 1933. Child guidance clinics employed clinical teams made up of newly established professionals: a psychiatrist, a psychologist, and a psychiatric social worker. Members of these clinical teams pooled their different perspectives to provide treatment sensitive to all aspects of the child's situation. Established as facilities to treat all maladjusted children in a community, the new clinics cooperated with existing social welfare, educational, and medical services to reach the widest range of children.
The child guidance movement of the early 1920s embodied the optimism and vigorous outreach of the MENTAL HYGIENE movement–psychiatry's early-twentieth-century push into the community, to educate the public about mental illness, identify its early signs, and it was hoped, to prevent it. The very term guidance suggests something between education and nurture on the one hand, and medical models of treatment and cure, on the other. By the 1930s, however, child guidance was a clearly delineated medical endeavor, aimed at treating a population of children with mild behavioral and emotional problems within the confines of clinic offices. Gone was the practice of early intervention in children, the broad local outreach linking clinics to networks of child-helping services, and identifying problems in children appearing in a variety of locations throughout the community, especially immigrant and poor children.
Nevertheless, child guidance continued to direct itself toward the same at-risk population: treatment of the so-called problem child. Child guidance defined the problem child as a child of normal intelligence, exhibiting a range of behavior and psychological problems, which were lumped together in a category called maladjustment. Indications of such maladjustments ranged from thumb sucking, nail biting, enuresis, and night terrors, in younger children, to personality traits such as sensitiveness, seclusiveness, apathy, excessive imagination, and fanciful lying. Also included was a category of undesirable behavior in older children such as disobedience, teasing, bullying, temper tantrums, seeking bad companions, keeping late hours, and engaging in sexual activities.
The problem child in the early movement was a social problem; its definition signified nonconformity to socially defined norms of behavior. The clinics were invested with social importance, responsible for enforcing norms of behavior and preventing social deviance. By 1930, child guidance began to help individual children whose problems were seen as important only to themselves and their families. The focus of problems had changed from an aggressive, extroverted, misbehaving child, to the internal psychological and emotional states of children. Child psychiatrists, psychologists and psychiatric social workers, saw their work as medical; diagnosing psychological disorders in children. This shift brought about a marked change in the social characteristics of the problem child. The social agenda of child guidance in the 1920s reached poorer, immigrant children, on whom it imposed middle-class standards of conformity. By the 1930s, child guidance treated an increasingly middle-class, native born population: the children of anxious, educated parents. With this profound change in focus, child guidance clinics became centers of research and treatment for the continually shifting population of problem children in the community.
Horn, Margo. 1989. Before It's Too Late: The Child Guidance Movement in the United States 1922–1945. Philadelphia: Temple University Press.
Jones, Kathleen. 1999. Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority. Cambridge, MA: Harvard University Press.