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EACHERS today are gradually acquiring many scientific methods, especially in the approach to such classroom problems as the more accurate measurement of the general learning ability of pupils and of their achievement in school subjects. They are furthermore applying recent research findings in regard to school hygiene and classroom management, and bringing to bear upon their daily teaching many newly discovered facts concerning the psychology of learning, etc. The point of view of psychiatric social work, though likely to overlap in part some other already familiar approaches to the problem of pupil adjustment and effectiveness, will nevertheless add another serviceable technique to these. The reason for the inclusion of the term psychiatric here, rather than merely using the words social service alone, is for the purpose of emphasizing the search for mental or psychological causes in analyzing, from the standpoint of mental medicine, the moral and social difficulties from which children suffer, or because of which they are maladjusted in school or in their life outside of school. The approach of social psychiatry is one which includes in the scope of its analysis of human maladjustment the intimate details of the individual's biography, relating them to those present environmental conditions to which he is not adequately adjusted.

The trend in mental hygiene is away from the symptoms, or the outward manifestations of disease, to the patients' biographic

or social background. The war-time and civil experience with adult neurotics has brought out conclusively that the mere removal of symptoms is often but a sham. Certain soldiers suffering from war neurosis or shell shock, who had been cured of all outward symptoms of nervous or mental disturbance, went to pieces at the shrill sound of the whistle on the French train on which they left the hospital. Previous to their departure, the symptoms had been removed. The basic condition of maladjustment to active military duty, however, unknown often both to the patient and to the physician, was ever ready to cause the symptoms to reappear. Likewise with children, the symptoms shown, while deserving of description and study, are often not the most essential factor in connection with the attainment of an understanding of the child's true difficulty and the control of it.

The child who is fidgety, or one who is sensitive to the point of ready tearfulness at a slight reprimand, or one who is subject to terrors or sudden spells, is not likely to be helped by emphasizing these symptomatic expressions. The particular expression, in fact, is often a matter of accident; if it is not one symptom it is another. The true underlying causes must be sought. These are frequently discerned by observation and study of the background facts in the child's biography which are actually bringing on and maintaining them. The method of finding and understanding these underlying facts should be brought vividly before stu

dents in teacher training institutions; and it is the purpose here to indicate the importance of this knowledge and how instruction in it may be accomplished.

Teachers need, for example, to use the social psychiatric technique in determining the mental make-up and social background of "problem children" in their classes. The number of such pupils varies from school to school. The ordinary commercially conducted private boarding school will be apt to be more fruitful in problem cases than the public school of a good middle class neighborhood, for the former is apt to draw "spoilt" children, children who have had inadequate parental care, and those from broken homes, while the latter will be likely to get its pupils from fairly good homes, where a devoted interest is taken in the child, where restrictions of conduct are maintained and good behavior taught both by precept and example. Even though a class in the public school were ordinarily to contain but few serious problem children; one such pupil may possibly outdo the rest of the class in his drain upon the teacher's nervous energy.

A "problem child" is often a serious moral problem for the teacher. She may find herself able to turn her energies to the rest of the children of her class only if she neglects or humors a "problem case." If, however, she determines to hold one of these "problems" to the regular class schedule to compel him, for example, to do his arithmetic when the arithmetic hour comes, and not whenever he happens to feel like it ( at all)-and insists upon her demand, a scene is likely to be forthcoming, which may lose half-an-hour of all the children's time and have a deleterious influence upon class morale. To neglect the problem child is dishonorable; to humor him cowardly; to attempt to reform him or to "break" his will, a serious wrong to the rest of the class whose time in arithmetic or writing is taken up witnessing the usually unsuccessful attempt to "tame" this child. The removal of the difficult or ill-adjusted child to an opportunity class, moreover, is not likely to be possi

ble in the smaller schools for some time to come. Consequently it devolves upon the teacher-training institutions to be cerned about this question with a view to preparing the future teacher to make a reasonable attempt to meet difficulties of this sort.

It seems therefore advisable to give all teachers some training in the social psychiatric viewpoint in order to give them a more objective attitude toward such children and a serviceable technique for attacking the cure of their difficulties.

Perhaps the first and most essential lesson will be that which impresses upon the teacher the fact that she must not consider the child's behavior in relation to herself, but rather view it objectively as a nurse regards the signs of disease displayed by a patient. In fact, this somewhat detached attitude is a healthy one for all teachers to assume toward all children and their responses; a too personal attitude on the part of the teacher, an attitude which refers the acts of the children to herself as perhaps insulting or flattering, is likely to cause the teacher to be in sad need of mental hygiene for herself before long.

Children's clinics (often called child guidance clinics) such as are conducted in the large cities, are going to be a rarity elsewhere in the country, especially in the rural sections, for probably another generation. This is due to the fact that the cost of maintenance of such clinics is prohibitive for most communities. A minimal staff for a child guidance clinic would be a psychiatrist, a psychologist, and a social worker. The hope of obtaining the advantages of mental hygiene guidance in the rural schools rests in the development of the "county-unit plan" or some similar form of organization, with a mobile child guidance clinic at the disposal of the smallest rural school. Until the people realize the advantages of the county-unit plan, and even thereafter, it is very necessary that teachers who go out into the schools be trained to understand the abnormal mental and social manifestations likely to be presented by their pupils.

Teacher-training institutions, by working out practical courses in social case work, can give students a suggestive scheme of approach to problem cases and also to the other abnormal manifestations indicative of poor mental adaptation in young children. Teachers with this training will have a more adequate method of response to atypical reactions in children than the distress and worry which such children usually arouse in the present generation of teachers, or what is worse, the attitude of indifference and neglect toward children so affected, and the toleration of their whims for the sake of peace in the classroom.

While we might think of psychiatric social work as developed primarily for abnormal pupils it is well to emphasize that it is actually serviceable for all children. Attention to mental hygiene is every teacher's duty. Psychiatric social work is largely the application of the principles and methods of mental hygiene to the study of personal or social maladjustment. There is almost unlimited opportunity in the classroom for the application of such methods. For while the average parents have made a beginning in the realization of the significance of physical hygiene, the concept of mental hygiene has as yet but reached a small minority of parents. Indeed, few pupils in the ordinary schoolroom are free from some signs of mental maladjustment. Most of it is not serious; but all of it contains the potentials for unhappiness-even failure.

Teachers need to know how to analyze the conditions underlying the behavior of the child whose mental attitude is described by one or more traits of which the following are examples: moody, indifferent, disinterested, inattentive, lazy, vicious, mean, nervous, irritable, hateful, unruly, bashful. Since the teacher has the child during a period when many of his social and mental attitudes are still plastic, she has opportunity to try out a great many means for alleviating such undesirable conditions. Moreover, gaining a knowledge of the homelife and mental background of children gives a teacher better understanding of the causes

which underlie any abnormal conditions she may observe in a child. Knowledge may also remove the depressing feelings of helplessness, shame, and despair, when facing a typical behavior in the classroom.

One of the next great steps in education will be along the lines of personality guidance. Methods will be developed for directing social attitudes and cultivating personality traits which will make for a better individual development in these respects. The child will be trained carefully with a view to making him an effective total personality. His mind is now so trained as to make him a more or less loosely coördinated collection of separate skills and miscellaneous, ill-assorted knowledge. The ideal of education will then be mental integration. It is clear that when that time comes the principles of mental hygiene will be employed extensively by the ordinary classroom teacher.

The problem of how to introduce instruction in the point of view of psychiatric social service is one of the first questions which the thoughtful reader will raise. The already over-crowded curriculum of the twoyear teacher-training course has little room for new subject-matter unless it be correlated or sandwiched in with some already existing course. The technique of psychiatric social service as applied in connection with mental hospital cases is highly specialized. It takes months of training and experience to meet the requirements of the ordinary training course at psychopathic hospitals. To attempt to give the teacher in training a full course in psychiatric social work would mean for a time to discontinue all of her other work. Enough can be done, however, to at least make a start on the problem. It would be very helpful of course, if all prospective teachers were required or, at least, advised to devote six weeks during one summer to social service work. The information and viewpoints obtained from such experience would be extremely valuable in their daily problems as teachers. But there are too many practical difficulties in the way of establishing and attaining such a requirement at the

present time. However, there is no reason why the ordinary sociology or psychology courses could not make room for the teaching of more concrete information regarding mental hygiene. And it is therefore suggested that for the present this work be correlated with the study of psychology and of sociology.

A more intimate correlation is needed between the introductory psychology course and the work in sociology. The former should devote less time to such topics as sensation and the nervous system (which strictly speaking are anatomy and physiology anyway), and more time to the consideration of everyday problems of human nature, with practical discussions of the significance to the individual from the standpoint of mental hygiene of such things as: ambition, concentration, daydreaming, decision, depression, energy, fatigue, ideas of superiority and inferiority, insanity, interests, memory, moods, nervousness, personality, recreation, self-consciousness, selfrespect, sex, sleep, speech defects, supersensitiveness, Vocational guidance, will power, worry, and other similar matters of genuine interest to students. The sociology course might include introductory instruction in psychiatric social service work. This might be given by using a number of case studies illustrating the outworking of the above mentioned aspects of the child's mind in determining the kind of adjustment he makes in the face of modern social life. Of course, the most instructive procedure would be to select children from the training school, and, after some instruction, have the future teachers attempt to work up case studies of them. This is not always feasible, due to the fact that this procedure might not be popular, especially in the small community. Parents might feel that their privacy was being trespassed upon. Students would therefore ordinarily have to have recourse to printed accounts of such cases. No better source could be desired for this work than the publications of the Joint Committee of the Methods of Preventing

Delinquency, notably two extremely interesting Studies: Three Problem Children and The Problem Child in School. These books are mentioned specifically because they give concrete case material and practical methods.2

The ordinary teacher may not encounter many "problem children" during her teaching career. She will, however, encounter many mentally maladjusted children, though these may not be severely enough affected to warrant calling them "problem children." These she may be able to help considerably; in many instances the effects will be so salutary that she will get considerable satisfaction from the accomplishment. The "problem children," on the contrary, are more difficult to help, to say nothing of cure. However, upon analysis and study, "problem children" become less of a painful dread and worry to the teacher and more interesting to her because of the riddles of personality they present. After all, so much of what we hate and dread in mental abnormality or maladjustment we dislike because of our ignorance.

The young teacher, like the proverbial wife of the moral derelict, feels sure of her ability to cure and to reform. Only too often, unfortunately, cure is not achieved. The teacher will have to be satisfied ordinarily with noting an improvement in the pupils she has worked with. Whether or not complete cure is possible in cases of mental maladjustment, the teacher needs to know how to use the most adequate technique in order to be able to try at least to institute treatment of such cases. Instruction in the viewpoint of social psychiatry in teacher-training institutions, would be a means of insuring some practical instruction in the application of mental hygiene to the problems of pupil maladjustment as they come to the notice of the observing teacher.

'Published at 50 East 42nd Street, New York City, New York.

2Supplementary reading could be obtained in the form of reprints published by the National Committee for Mental Hygiene, New York, New York, and by readings in Mental Hygiene, a magazine which this organization publishes.