Monday, July 21, 2008

Ambassadors of Health

So Jon, who has never so much as read a blog, tells me he's vying for a highly prestigious grant. A man of many observable muscles (a walking anatomy lesson so-to-speak) and 1.1% body fat, Jon is a fitness expert. His grant proposes to take high risk inner city Baltimore youth, perhaps even high school drop-outs working on their GEDs, and train them to be certified as fitness and nutritional experts to help a larger population in neighborhoods where healthy eating and regular exercise are not part of the daily routine. In the inner city, lifestyle choices lead to a myriad of illnesses and early-age deaths. So working with the kids to be ambassadors of healthier living: Wow! What a goal; how can you not love the guy?

If you haven't seen it, by all means, watch Hard Times at Douglas High-- an HBO documentary which takes a peek at the population Jon's wants to target. Single parents, teen moms, drug abuse, and incarceration are all the norm. The soccer moms with their minivans and juicy boxes are no where to be found. The children speak a distorted form of English, and even some of the faculty have trouble putting together well-constructed sentences. Standards are set such that it's the teacher's fault if the kids don't pass-- all of which leads to lowering the standards. One child at Douglas scored over 1000 on the SATs and 1 child passed the Maryland proficiency exams in math. And while the 9th grade class has 500 students, many of them repeaters, the graduating class has 60% fewer students with only 200.

Jon asked me if I know anyone who specializes in building self-esteem from a psychological perspective, something he'd like to incorporate into his program. I hesitated, I don't. Certainly, if a child has a psychiatric disorder, it would be good to treat that illness. People with depression often feel badly about themselves, and with treatment, some of these symptoms can get better. But what about kids who feel badly about themselves because they've had rough lives, parental desertion, academic struggles, behavioral and legal issues, neglect, and even abuse? Does counseling make it better? I'm left to say "maybe." I don't know that it doesn't and I don't know that it does. I do know that success builds confidence and that builds self-esteem. And we all know there are Invulnerable, resilient kids out there, people who will succeed or even excel in spite of unthinkable adversities. They are the best.

Okay, my disclaimer of the post: I have no idea what helps struggling kids excel. I don't work with kids, I haven't read the studies, I just like to ramble.

I know as much about what makes kids succeed as I do about betting on horses, so let me try that stab in the dark. I don't know how much counseling would help, but if it were my money and I were deciding where to put it, I wouldn't allocate spending it on psychological treatments in the absence of a psychiatric disorder. Here's what I'd work on: things that help kids feel more confident in a concrete and tangible way. Counseling can feel cliche-- yup, we're all wonderful and special and we can grow up to be anything we want if only we put our mind to it. These kids aren't much for buying that rhetoric. So here's what do I (the rambling, clueless, blogger) think would help inner city kids succeed:

  • Jon. He's kind and attentive and very encouraging and who needs a counselor when you have him saying "you're doing a great job!"

  • One-on-one reading remediation. Oy, the textbook for this fitness certification trainer thing looked like one of my medical school texts. This isn't easy and any kid who can get through it will feel pretty confident by the end.

  • Dental work. Okay, you think I'm kidding, but this is not a population with routine access to orthodontics and dental care and bad teeth make it harder to get employment (my own theory, no research).

  • Wardrobe consultation. Watch the documentary and tell me there's one boy in there you'd hire to do anything besides sell drugs.

The point of this post isn't to rag on inner city life, and it certainly isn't to discourage Jon. The world needs more Jons, more idealists, more people willing to take on tasks that feel hard. The point is to say that I'm not sure individual counseling or psychotherapy is the place to start to build the confidence needed to get out of a lifestyle that lends itself to festering in poverty. Job coaching, skills building, health care and dental maintenance, treatment of psychiatric disorders, education, education, and education are the way to go.

And Jon, I hope you get your grant and I hope you like being on our blog!