Interviewers were John Riess (JOHN:), Joan X (JOAN:) and Michael Burroughs (MICHAEL:)...

JOHN: I would like to interview you about your work with the parents of the children. I think this is a valuable and critical component of the Si a la Vida program and one that is not well understood nor appreciated by most people. I am interested in what you are currently doing within the budget as well as what you would like to do if the budget were increased.

From what I understand from reading your reports in the individual case files, there are four parts to the Parents of the Family program that involves follow-up at different stages of the boys’ development [see "Support Group for Parents" on page 2].

The first part I will call the baseline social investigation, in which you gather information from the family's perspective about the circumstances revolving around why the chavalo left his home and went onto the streets to live. (The chavalo's explanation, of course, is the first accounting of his reasons for going onto the street) This not only provides an understanding of the root of the problem for that particular chavalo but also provides the staff with the opportunity to design a treatment strategy tailored to that social history.

The second part involves the half-day monthly parent-training session in which there are lectures, discussion groups and peer support workshops that allow those parents attending to share their struggles in guiding, educating and disciplining their children.

The third part is preparation of the parents for the reintegration of the child back into the family after being rescued from the streets and spending an extended period of time in rehabilitation at the residential treatment centers in Managua and on the island of Ometepe.

The fourth and final part of the Parents of the Family program is the follow-up of those who have "graduated" and are now living with their families again. I understand that this component is not as fully developed as you might like due to budget constraints.

JUANITA: Yes, follow-up is an integral and important part of the program in which we do an evaluation of the reintegration to ensure that the chavalos (Nicaraguan term of endearment for the "boys") are taking advantage of the social orientation and behavioral tools that they learned during their rehabilitation. We are interested in assessing the extent to which the community is supportive, whether the chavalo is involved in the school, and how he is responding to the support. The problem facing us is the high costs involved in providing follow-up to those chavalos who live in homes a long way from Managua where my office is located.

Besides a budget for travel, we also need resources to develop a program dedicated to family assistance in which we would design alternatives for parents to support them in maintaining the chavalo in the home once he has returned from the treatment centers.

JOHN: Are the additional costs required to implement the full scale integration and follow-up program that you envision the costs of additional staff time or primarily the costs of transportation, meals, and lodging.

JUANITA: Staff time is available. For example, I have programmed two home visits a week. Staffing is not the problem. The travel costs is the impediment to the program.

JOHN: I am curious if you have many problems placing a chavalo in school when he returns to his family after attending school while at the residential center.

JUANITA: No, quite the contrary. When we look for an placement in the school, we explain to the school all the academic preparation done by the program. Schools then usually respond by giving priority to the chavalos. If we explain well what has been done in terms of academic preparation, school principals will be willing to help. Nicaraguan law requires school priority for street kids, but the problem is with gaining accessed to vocational or technical training centers.

The major challenge to successful reintegration is when the family does not help the chavalo— help in the sense of ethical guidance or support. The chavalo arrives at his home and then returns to the program. Although the chavalos have changed and now have the tools for rehabilitation, are more mature, and can overcome some of their difficulties, when they return to the same nuclear family and encounter the same difficulties, that's where they can fall down. [Note: SALV provides the boys who return to their families with school supplies such as uniforms, book bag, and writing tablets.]

JOHN: What about the poverty? For example, Adan lives with his mother, siblings, and step father on a noisy major thoroughfare in a one room house with walls made of tin roofing materials, an earthen floor, no privacy, no place to study, a very disorganized and disheveled environment.

JUANITA: Sure, there's poverty but more importantly there are also family members addicted to drugs and alcohol. And even if the family is fine, in the neighborhood you find drug dealers, alcoholics, and gangs, all of which the chavalo has to learn to avoid.

JOHN: Would you please share with us now a description of what I've referred to as the baseline social investigation, certainly the most developed component of the family program.

JUANITA: Yes. The baseline investigation is structured but informal. We want to learn who the family consists of but we are careful not to ask about sensitive areas. We are always aware that we are just beginning to develop a rapport and friendly relationship with the family. Sometimes the family is belligerent and doesn't greet us with open arms. Not all but some. We start off observing the family, listening to them, and after a while we start becoming aware about their situation. In the beginning, we just gather the most essential information such as when the chavalo was born, whether he has an official birth record (important for school registration and other official functions), when and why he went onto the streets to live. If there's a need for psychological counseling, I put the psychologist directly in touch with the family to gather a more detailed behavioral history. In terms of the economic circumstances, unfortunately not one of the chavalos comes from a comfortable home. Everyone is living in poverty.

JOHN: After gaining the family's confidence, can you enter into candid discussions about the chavalo and gather critical information about the family's functioning?

JUANITA: That's it. In the beginning, we don't get too analytical. More than anything, we explain what Sí a la Vida is all about, seek parental agreement to enroll their kids in the residential rehabilitation program we offer, invite them to visit the residential treatment center, and encourage their agree participation in the monthly parent meetings.

JOHN: I don't know if this is an extreme case but I'm aware that one of the chavalos, Santos, wouldn't talk about his parents nor reveal where the lived for the first two years he was in the program.

JUANITA: Yeah, in the case of Santos, the psychologist recommended that we not pressure him to provide that information because he was a child suffering from posttraumatic stress after experiencing an earthquake in his village. He would never tell us where he came from, not until he moved into the second phase of rehab on the island. Almost two years after leaving the Managua residential center. His mother is actually a single woman with many problems but Santos has now returned to her. A fantastic accomplishment in light of his long-term reticence to even talk about his family.

JOHN: The one component we have yet to talk about is the parent training. Would you care to elaborate about that?

JUANITA: Yes, those monthly meeting have an educational and preparatory focus for the family. The learn about how their sons are going to be treated at the residential program. More importantly than providing parenting tools, the parents share their experiences with raising kids. The psychologist has helped by using her technical skills to encourage discussion and participation in the groups. The idea is to strengthen the parenting skills. The intent is that the parents realize that the services offered at the residential treatment center can only be effective if done in cooperation with the work done at home by the parents raising their kids.

But the parent training program also experiences many problems. Parent attendance at the monthly meetings can be sporadic either because the parent needs to work and cannot afford coming to the meeting or because they are not committed to the monthly meeting schedule. This is true, of course, for some but not for all. Over all, parental participation has been quite good.

JOHN: What percentage of the parents regularly come to the monthly meetings?

JUANITA: 75-80 % for those who live in or near Managua participate regularly. For those who live a long distance from Managua where the meetings are held, they might participate every third month and or possibly once per year.

JOHN: And when the parents of those chavalos who are in the Managua center come in for the monthly meeting, can they visit with their kids?

JUANITA: Yes, of course. We are implementing home visits that don't involve lectures or discussions but bring together the kids and their families, meaning not just the parents but the siblings, grandparents, uncles, and aunts. Family activities include games such as smashing the piñatas or having a luncheon together—some sort of informal gathering.

JOHN: There are many reasons why kids leave their homes to go onto the streets. One reason is a psychiatric problem like hyperactivity and attention deficit. Would you share how you train parents to deal with that type of situation?

JUANITA: Yes, that type of training is coordinated by the psychologist who shares literature about such problems. Many times the parents aren't very tolerant about the behavior of their kids when they are psychiatrically disturbed. As we discussed previously, because of poverty and mistreatment and so forth, some of the kids experience psychiatric problems. But the psychologist studies the specific cases of the kids and we discuss the cases in our team meetings and design alternatives for treatment. In some cases, the characteristic of the psychiatric problems are beyond our capacity to deal with them, in which case we look for alternative resources—specialists who can handle those problems and with whom we can coordinate our efforts. [Note: On Ometepe, staff manage all psych problems under the direction and supervision of a psychiatrist who makes regular site visits, often involving temporary use of psychotropic medicines to help child overcome his problem and take control of his behavior.]

JOHN: Who attends the monthly meetings with the parents—just you or other members of the team such as the site coordinator, the tutors, the psychologist?

JUANITA: The entire staff attends. Many times one or another staff is unavailable but the ideal situation is having every staff member participate, including someone from the Ometepe staff who gives a report on how the kids are doing in school, how they are behaving in general and perhaps if one of them is ready to be returned to and reintegrated with their family.

JOHN: I'm aware that some of the kids on Ometepe go to Jonathan's house on the day of the monthly meeting in Managua so that they can use Jonathan's telephone to talk with their parents who are attending the monthly meeting. Is that the norm?

JUANITA: We try to do foster communication between the chavalos and their parents but of course we can't achieve this for each kid every month.

JOHN: I would assume that your work is highly coordinated with the staff on Ometepe because you have to prepare the parents for their kids returning to live with them.

JUANITA: That's definitely so.

JOHN: I understand that you and the Ometepe staff have developed a sort of pilot or test reintegration plan in which the chavalos from Ometepe are returned to their families for brief periods during holidays and school vacations.

JUANITA: Yes, we consider it quite important to not just send the chavalos to their families at the end point but rather to reintroduce the kids into the family various times before the final reintegration, a process that little by little helps adjust both parents and kids to the final return home. Because after such a long time of not being in the home and undergoing so many changes, we apply this strategy of short-term temporary home stays. Many times, the chavalos encounter problems during the home stays and are subject to relapse.

JOHN: As I have shared with you before, I have reviewed many charts and am highly impressed with the informative and comprehensive quality of your reports and social investigations. You clearly have developed a strong rapport and relationship with the parents and I would like to congratulate you for your effective work. I don't have any further questions. Perhaps my colleagues would like to ask you something or perhaps you would like to comment on something which I have not asked about.

JUANITA: I believe that SALV, despite the complex situation here in Nicaragua, and with the help of all the good people from foreign countries, has achieved a lot, although lamentably the circumstances aren't favorable. Our job is to help the chavalos transform their behavior which didn't allow them to develop as kids. Helping them improve their general well being would not have been possible without the aid of people outside Nicaragua.

JOAN: Do you believe SALV has been successful in preparing the older adolescents technically for a job in the professions or trades?

JUANITA: I think that a third stage such as that type of vocational training is very important although we are a little weak in that arena at the current time. There's the will to develop such courses but we lack the resources. Such a program would be a good compliment to the two prior stages (rescue from the street and drug rehabilitation-educational preparation). The kids here at the Managua center come directly off the streets. In the second phase on Ometepe, where the chavalos have more autonomy and responsibility and are prepared for greater independence. The vocational program you propose would be the next phase in the future.

JOHN: Can you estimate for us what percentage of the chavalos already reintegrated with their families succeed in remaining there?

JUANITA: The percentage of those reintegrated who remain with their families, from my experience, would be 70%. [Note: 90% retention rate for kids integrated from Ometepe.]

MICHAEL: What percentage of the kids are reintegrated with their families?

JUANITA: Of the chavalos who go to Ometepe, 90% return to their homes or homes of family members. And almost all of the kids who come to the Managua center are transferred to Ometepe after they have stabilized here at the Managua project site. Some kids, of course, don't need to go to Ometepe because they don't require that level of intensive support. After a period of time in the Managua project, they are prepared to return to their families.

JOHN: How long do the kids without addictions stay in the Managua residential center.

JUANITA: Many times they stay to finish the school year, perhaps 4-6 months.

JOHN: And for those addicted to drugs, how long do they stay in Managua before being transferred to Ometepe?

JUANITA: Many times, 6 months, 8 months or one year.