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Little Victories Every Day

“We’re a modest agency,” she continues. “We don’t have the resources to mount a huge effort. But we can help one family at a time; that’s our strategy. We’re trying to build self-sufficiency and independence, and promote healthy child development. But we do it the only way we can, one at a time.”

Florence Crittenton Programs of South Carolina, Inc. has been known for its work with unmarried pregnant women in Charleston County since its founding in 1897. The agency serves a clientele of single mothers and mothers-to-be, and provides screening and evaluation, counseling services, healthcare information, academic instruction, and acts as a liaison to other social service agencies within the community.

Traditionally, the agency helped young mothers through the stages of prenatal care, hospitalization, and post-partum care. More recently, it has shifted its focus to provide more services to mothers and children for up to two years after birth, to the critical early years of children’s growth and development, and the crucial years of mothers learning how to grow and nurture their families – and themselves – in healthy ways.

In 1997, Florence Crittenton started its Family Development Program, which provides comprehensive home-based services to at-risk, single parent families with infants and young children. This program serves approximately 50 families every year. In 1999, Florence Crittenton expanded to include The Nunan Street Project, which consists of 10 subsidized apartments in downtown Charleston for client families to live in for up to two years, while participating in the full range of Crittenton services. Both programs have received generous support from The Duke Endowment over several years.

Linda Flanagan was the first program director of The Family Development Program. She worked for many years in the Florida Department of Public Welfare before going to Charlotte to work in reproductive health care for women then coming to Charleston and the Florence Crittenton agency in 1992. The program that Flanagan started is now run by Sarah Gainey, who first worked with the program as an intern while completing her master’s degree in social work from USC, Columbia. She got her degree in 2003, worked briefly in substance abuse treatment in Charleston, then returned to Florence Crittenton.

“I really like the population we serve, the work that we do,” says Gainey. “I like that it is focused on the strengths of our clients. In mental health treatment, there’s lot of focus on pathology, on diagnosing problems and treatment. We use something called the ‘strength-based’ approach – you see what’s good and you build on that.”

The agency learned this “strength-based” methodology from Dr. Victor Bernstein of the University of Chicago. One of his principles is to build “resilience” in children, best done through a significant relationship with a caring adult. Bernstein’s influence is more than theoretical, however. He comes once a year for staff training and counsel.

“Most of our clients are low income and very close to the edge,” Flanagan says. “So we have to pay attention to problems. What we learned from Dr. Bernstein is how to keep our focus, how to deal with all the problems, and then re-focus on what’s going right. One of the things that gave us the most difficulty at first was that we were being overwhelmed by the problems of the adults. They’re very serious. But we were never able to get to the work with the children, starting them out on a path of healthy development. Now we can, because that’s where we focus our energies.”

That strength-based approach has another benefit as well, giving a much-needed boost to staff morale. “The difficulty in this work is burnout,” says Flanagan. “If you only focus on the problems and try to fix them, it won’t work. Our clients are going to have ongoing problems that they’ll have to deal with all their lives. If you can shift your focus so you’re supporting growth, so that they’ll have the skills they need to problem-solve and fix things on their own, it’s a much more affirming way of working – for everybody.”

One of its affirming programs is called Ages and Stages, a developmental screening of mother and child. It consists of a series of questions about the child, grouped around growth and gross motor skills, communication, socialization, fine motor skills, hearing, problem solving, certain types of delays. The process usually takes place in the family’s home and is often videotaped, using normal activities such as meal times, snacks, or bath time. The tapes are reviewed with the mother, and some times other family members, to see the interaction between mother and child.

“It’s a great way to teach parents what’s normal, what to expect, without being pedantic about it,” says Donna Barr, an outreach Social worker on the Crittenton staff. “We try to reinforce the positive rather than criticize behavior. The video is helpful because the mothers see it for themselves when something doesn’t work.”

An Ages and Stages interview with a young mother named Candra and her daughter Essence demonstrates the power of the sessions. “The video interviews are helpful,” says Candra, “because they let me step back and take a look at myself, to see how I’m doing as a mother. Some things I’ve learned are new. I have another child, a son, and one thing I’ve learned is that each child is different.”

“You can see in the tapes that Candra knows a lot about this child,” says Barr. “She’s the expert; she knows more than anyone else. We understand and respect the fact that parents know a lot about their children. We want to mine that information. It directs us in how we deal with each family. We also bring information to the parents, from an expert’s point of view, but we start with their knowledge and understanding of their own children.”

One of the surprising things to the staff has been how easily they’ve been able to find strength in every family. “If you go in and do a catalog of all the problems, you would think there’s no way,” says Flanagan. “They come to us with a constellation of troubles that can set you back. The pregnancy is almost an aside. In spite of that, we see amazing nurturing going on. Every mother we work with wants a better life for her child. But they can get beat up by ‘the forces of risk,’ as Dr. Bernstein calls them. They have real obstacles to their goals.”

The agency has problems, however, to go along with all the success. One is tracking results. It is difficult if not impossible for such a small agency to do longitudinal studies. They just don’t have the resources, and the population is very difficult to track – they move a lot. The staff does track outcomes that have a shorter horizon, what actually happens in their program – how many get developmental screenings, how many get regular doctor visits and inoculations, the number of referrals, income levels, job training, schooling – and the results are impressive.

Another problem is demand for services, which is always greater than the agency can fill. They get most of their referrals for the Family Development Program from other social service agencies or other Florence Crittenton programs. There is a waiting list. Staff members would love to expand the program, but it is an expensive proposition. Funding is tighter than ever, with both federal and state assistance programs slashing funding and recent stock market declines hurting private foundation portfolios.

“It’s a nervous time for non-profits,” says Flanagan.

So what keeps the staff going?

“With all of the problems, we see the most incredible caretaking and nurturing,” Flanagan says. “The spark of hope is gratifying; it keeps us going. And as for me, I like adolescents. That really helps. And I live to see those little victories every day. That’s how you make progress, one family at a time.”