"My doctor told me I have to gain 35 pounds," says the young woman peevishly as she opens the door for Mirian Lopez, a social worker. "I'm not gainin' that much. I'm not gonna get fat."
The 21-year-old Cheryl (not her real name) is in her second trimester, and because she's short and slight, a smoker, and unmarried her pregnancy is high risk. For two months Lopez has been visiting her at her family's apartment for an hour every other week as part of the West Town Healthy Families Project, a nine-month-old voluntary program intended to help prevent child abuse. Cheryl, who's unemployed, hadn't had any prenatal care before Lopez started coming--she didn't even have a doctor.
Lopez, who has two children of her own, explains to Cheryl that she needs to gain weight for the sake of her baby. She asks what else the doctor told her, and Cheryl says defensively that the doctor thought her weight was OK. Then she says she wants to have an ultrasound: "My boyfriend is obsessed with knowing what sex it is." She says he desperately wants a boy.
When Lopez asks what she's doing about her smoking, Cheryl folds her arms across her chest and says she's cutting down. She'd promised to attend a class on quitting, but Lopez knows she never showed up. Lopez suggests that the health educator who gave the class come to the apartment, then takes out a calendar and pushes Cheryl to agree to a day and a time.
Lopez pulls out a form, "What I'd Like for My Child," and explains, "This is about the dreams and goals you have for you and your baby. We'll prioritize these goals and review them in six months to see what you've accomplished." She reads through a list of 24 adjectives and asks which one Cheryl most wants her baby to be.
"I want my baby to be smart," she says immediately, and laughs. "That's first." Lopez hesitates, then asks, what about when the baby's first born?
Cheryl sits silent, looking at the list. "Healthy should be one," she finally says. Lopez smiles encouragingly and asks, what else?
Cheryl pauses, then says, "In my family, respectful." Her next choice is "well behaved," and Lopez asks for one more. Cheryl stares at the list for a long time and says, "Every one of them should all come into one." Lopez presses her, and at last Cheryl says, "I want the baby to be happy."
"What do you think you can do now to help your baby develop these characteristics?" asks Lopez, who says later that when she once asked Cheryl what she'd do with her baby when it cried, she said she'd hand it to her mother. "What do you need to do for the baby to be healthy?"
"Take vitamins. Watch what I eat."
Cheryl's niece, who looks as if she's about five, has been standing by Lopez's chair. The girl leans toward her and whispers a question.
"Get out of here," Cheryl snaps at her. "Get in the kitchen."
"I don't mind--it's OK," says Lopez. Then she asks, "Are you tired? Should I come back another time?"
Cheryl shakes her head and says, "She's always in the way, always has to be in here when I have company."
Lopez pauses again, then says, "What can you do now to help make your baby respectful?"
"If it's in here," Cheryl says irritably, pointing at her swollen belly, "I can't tell it to be respectful."
"Do you talk to your baby?" Lopez asks softly. "Do you feel comfortable doing that?"
"No. My boyfriend does, though."
Her niece has edged back into the living room, and Cheryl yells at her sister to make the girl stay out. Her sister shouts at her to come back in the kitchen.
"It's OK to talk to your baby," says Lopez.
"I'm not used to that. But my boyfriend, when he rubs cocoa butter on me, he goes "googie."' She lets out a short, sharp laugh.
Her niece reappears in the doorway, but when Cheryl yells at her again she goes back into the kitchen. The sister screams at the girl, who starts crying.
Lopez has moved on to a form that includes a list of free classes offered by the Humboldt Park Infant Mortality Reduction Initiative (HIMRI), the organization that administers the Healthy Families Project, and asks Cheryl if she'd like to take any. Cheryl looks over the list and says she isn't sure.
"How about building confidence as a parent? Would you like to learn about that?"
"That'd be fine."
"Would you like to learn about calming a crying baby? Or basic infant care?"
"That'd be fine."
"How about a class in self-esteem?"
Cheryl doesn't answer.
"What do you feel your strengths are, the things that are positive about you?"
"I can think of a lot of things," Lopez says gently.
Cheryl stares at her lap and finally says, "I don't usually talk about myself."
"But this would be good, because you'll realize what strengths you have. Do you need some help with that?"
"Are you a good daughter?"
"Yeah," she says. "I'm reliable."
"Are you a good wife?"
"I spoil him, even though sometimes he doesn't realize it."
"How about responsible? You're really good about keeping your appointments."
"Yup," she says, smiling awkwardly.
Lopez gives her a HIMRI calendar that shows when classes are offered and marks the ones Cheryl said she might be interested in. Then she goes over the appointments Cheryl has during the next week, with her doctor and the Women, Infants, and Children (WIC) office.
As the door closes behind her, Lopez can hear the niece crying again and Cheryl's sister telling her to shut up or go to bed. Lopez shakes her head and says, "I see trouble coming." She says she thinks that Cheryl only wants the baby to please her boyfriend. She doesn't think she's changed Cheryl's attitude much and wonders whether she's wasting her time, whether Cheryl is simply using her to get referrals to doctors and service agencies. And she wonders if she should call the Department of Children and Family Services about the niece. "But I'm telling you, once you call DCFS on a family you're usually not welcome anymore."
Two years ago a committee of the Healthy Start Consortium--a state-funded infant-mortality-reduction project--set out to find a program that would help lower the rate of child neglect, abuse, and homicide in West Town. They'd heard of a long-running home-visiting project in Hawaii that had been unusually successful in preventing child abuse, the prototype for Healthy Families programs around the country, and decided to adapt it to their poor, mostly Latino neighborhood. Fathers were to be encouraged to participate, as were all members of the extended family, especially the grandparents. The mothers were to be recruited as early in their pregnancies as possible. The social workers were to be bilingual paraprofessionals who lived in the community, and all materials for the clients were to be in Spanish as well as English. Five staff members, all women, were hired, then trained by the National Committee to Prevent Child Abuse, which instructs but doesn't oversee workers for Healthy Families programs. Last December the staff started interviewing clients.
The West Town Healthy Families Project is open to women pregnant for the first time and to first-time mothers whose children are under three months old; after that, behavioral patterns start to set and become harder to break. Because the maximum caseload for each of the three home visitors is 15, priority is given to families where a child is at higher risk of abuse. The staff have promised to stick with the families through the critical first five years of the child's life.
Women are recruited through flyers or referred to the project by schools, clinics, and social-service agencies. The mother is interviewed, asked what she's expecting of her child, what she knows about parenting, what kind of upbringing she had, what kind of stress she has in her life. Many things can push her into the high-risk category: being poor, having dropped out of high school, being a single parent. But, Lopez says, "Usually it's the history of their childhood that puts them at a high-risk level--that they were spanked as a child, or they were hit and it left marks, or because the maternal grandmother or grandfather is a drug addict or alcoholic." According to a 1990 study, an abused child is six times more likely to become an abusive parent than a child who wasn't abused. Yet Lopez has found that the greatest threat of abuse comes not from the mother but from other members of the family--the boyfriend, the grandmother, the grandfather. Which is why she also finds herself dealing with their problems--listening, helping them find work, medical care, or drug counseling.
The home visits, which usually last an hour to an hour and a half, are scheduled every other week for pregnant women and every week after the child is born; the visits taper off slowly after the first year, until by the fifth year the family is visited only once every three months. Home visits make it more likely that the mother will be there for the appointment--few fathers show up, though about half are part of their babies' lives--and they allow the social worker to see the baby's environment, meet the grandparents, pick the child up and discreetly look it over. The home visitors are state-mandated reporters, so if they see signs of abuse they're required to call DCFS.
But while the mothers are told right away that their home visitor is a mandated reporter, the project isn't marketed to the moms as child-abuse prevention. Because participation is voluntary, no one has to sign up, and no one has to stay. One flyer reads: "Do you live in West Town? Are you pregnant? Is this your first baby? Feeling nervous about being a new mom? . . . West Town Healthy Families offers home visiting, fun activities to help build your confidence as a mother, help in understanding what your baby needs, group activities and outings, support group for new mothers, parenting classes, someone to give you a helping hand."
Project coordinator Teresa Vazquez, who has one daughter and is pregnant, has a creative-writing degree but has worked in social-service organizations for several years; she believes that for the program to work it has to focus not on what's wrong with families but on what's right. "What we're trying to teach is first of all what strengths the mothers bring to parenting and their lives in general and how to apply those to the new situation of parenting." The program also focuses on what can be realistically taught: "How to keep their stress at a minimum, how to think safety in their home, what are the best practices in terms of discipline. And beyond that, that there be sympathy and understanding and that the child grow up with a sense of being valued and loved and nurtured. Optimally, in the long range what that will mean is children who have had good health throughout their lives, who are ready to learn once they go to school, and who, through observing the parent, have some skills in terms of problem solving, in terms of having a good amount of self-esteem.
"Parenting is not instinctual. What seems instinctual is what you have observed. And if that model is dysfunctional, then that is what will play itself out in your life--unless you find some other kind of coping mechanism to help make it work. We hope that we're one of those things that help people learn to cope."
Lopez climbs the stoop to a three-flat on North California, turns, and kicks the door hard with her heel. The doorbell doesn't work, and Monica Ayala and her parents live on the second floor.
Ayala was 17 and four months pregnant when she started the Healthy Families program; her son, Richard, is now four months old. A week ago Lopez had gone through the list of goals Ayala has for her son, and she'd quickly chosen the adjectives healthy, smart, well behaved, and happy--the same words Cheryl picked.
On this visit Lopez had planned to go through some information on basic child care and safety, but when she walks into the living room she sees a small jar of pureed carrots on the couch. When she asks how long Ayala's been feeding Richard baby food, Ayala answers shyly, with a slight accent, that she gave him his first taste the day before but he spit it out. Asked whether she's still breast-feeding, still supplementing with formula, Ayala says she is and that Richard is eating well and often. Lopez explains that ideally he shouldn't have solid foods until he's six months old, that starting him too early might cause him to develop allergies. "I know that you have good intentions," she says. "But you need to feed him appropriate foods."
Ayala, who's holding Richard on her lap, gently swaying back and forth with him, nods and smiles. Lopez takes the baby and rests him on his back along her thighs, chuckling at him and pumping his legs.
Lopez gives Ayala a list of things she should be eating to keep herself and Richard healthy and another list of things she shouldn't be eating because they pass through her milk. She suggests that Ayala get out of the house more often, but Ayala says she doesn't like to go beyond the front stoop.
When Richard starts fussing, Ayala immediately goes to the kitchen and comes back with a bottle. She takes Richard back from Lopez and cradles him half upright, carefully holding the bottle above him.
Lopez gives her a HIMRI calendar and helps her pick out a couple of classes, asks about Richard's doctor's appointments, digs into her bag for a WIC referral slip. By the time she gets up to leave, an hour has passed. She strokes Richard's cheek and says, "Mommy's doing a real good job with you. Just tell her not to feed you baby food, because you don't want to get sick."
Lopez, who's been a social worker since 1987, working mainly with the disabled, says she sometimes gets frustrated that she can't get beyond talking about basic health care. "I can't get on to the larger issues because I have to focus and refocus on the basic ones." Even though she'd explained to one young mother more than once why she shouldn't feed her baby cow's milk until he was a year old, one day she found out that the mother had fed him regular milk after running out of WIC coupons for formula. Even more dismaying, she'd heard that the mother had been selling the formula she had to buy clothes for the baby.
Frequently Lopez also has to spend time showing her clients such simple things as how to get around the city. "If I have to get on the bus with them and teach them, I'll do that." And she has to counter the advice of grandmothers who say that babies have to be fat or they won't be healthy, that their daughters need to put Karo syrup in the babies' water so they'll drink it, that they should use herbal remedies when their babies are sick.
Yet Lopez knows that dealing with basic issues is part of getting families to trust her enough that she can help them with the larger issue of their children's emotional well-being. "See, a client is not going to open up to you right away. Sometimes it takes months. You have to win that trust. We ask lots of questions when we interview them, but they're not necessarily sincere when they answer. Later on you find out that, wow, it's not what they said. It's something totally different. Some of them are really open to telling you what they've been through, what they're going through, but others are very reluctant." Which is why she tries never to look shocked. "You can't be surprised at what clients say, or next time they won't tell you something." And why she often makes more than one visit a week and is on call 24 hours a day. "You're constantly there to support them, to let them know, I'm here if you need to contact me in an emergency. If you just need someone to talk to, I'm here."
She also knows that dealing with such issues as health and safety is one way to shift a mother's mind-set toward preventing problems instead of simply punishing a child after it's done something "bad." Lopez often goes into a home and sees sharp objects and glasses within a baby's reach. "I tell them, if you don't want your baby to grab something, take it out of his reach. The kid does not know that glass breaks or that glass can cut his hand. They're curious. They want to see what it is, put it in their mouth. The parents are just assuming, this is bad." She holds out one hand and slaps it with the other. "I explain to the moms, and they say, "Oh my God, you're right.' Things that may be obvious to you and me are not necessarily obvious to them."
Changing people's attitudes about any issue, Lopez knows, is a long process. "It's just a lot of hard work--and slow. As a worker I can't have false expectations. When we tell the parent, "We're going to focus on what goals you want for your baby,' we have to be sure they're attainable, that they're realistic. And it takes time. Things don't happen overnight. They've been taught by their parents, so we have to break that cycle--which is pretty hard when you've been raised in a certain type of environment. But I tell them, "You can break it. You can definitely break the cycle.' I believe you can. You have to believe that."
Teresa Vazquez knows that a lot of young women are being missed by the program--in 1992 nearly 2,000 mothers living in West Town gave birth. She estimates that she'd need a staff of 40, not 5, to meet the needs of just the neighborhood's at-risk first-time mothers. There are only six additional Healthy Families programs in Chicago, all about the same size as West Town's. And the only other program in the city that offers similarly intensive parent training through home visits is the Ounce of Prevention Fund's Parents Too Soon, which has eight programs that serve a total of 450 to 500 women.
West Town Healthy Families has made a five-year commitment to its clients but has funding for just two years. Like most Healthy Families programs, it gets money from more than one source. This year the bulk of its $250,000 budget came from Healthy Start, which is funded with federal dollars through the Illinois Department of Public Health, though the project also got a $20,000 grant from the Ounce of Prevention Fund to look into expanding into Humboldt Park. Healthy Start's funding runs out in June 1996, and with it the grant for West Town Healthy Families.
There's a chance new funding could come through federal block grants to the states, but no one's sure yet how those funds are going to be distributed; moreover, Healthy Families will be competing for those funds with lots of bigger and better-established programs. Vazquez, who worked as a fund-raiser for several years, is alternately optimistic and pessimistic. She hopes to piece together a budget from small grants but admits that will be hard. "This is not unusual for any kind of innovative social-service program. Things are piloted, they're evaluated, they're proven to work--but as soon as you get the model down, the funding source disappears. It's heartbreaking, because you know that given the opportunity you can really touch people's lives. But the priorities in our country are elsewhere at this point."
Gaylord Gieseke, senior projects director at Voices for Illinois Children and cochair of a state task force that's working on a plan to set up Healthy Families programs statewide, says that because of the changing political climate in Springfield the task force didn't ask for money for additional programs this year. She was particularly concerned by some responses to the Healthy Families projects. "The far right is vehement that this is government intervention in the home--no matter how many times you say that no one has to participate and that there's no stigma to declining and the staff are community members."
Knowing that proving the program works is critical to getting funding, Vazquez calls a couple of clients every month and asks them to describe in detail what they do and don't like about the project. She's also pushing for a detailed evaluation by the National Committee to Prevent Child Abuse. But she's well aware that measuring something as complex and subjective as a shift in a parent's attitude is difficult. "Really we won't know for many years whether what we've done will make an impact. But I do believe that it will, even if it's in a small way."
Monica Ayala is sitting in her living room, holding Richard upright on her knee. He's teething, gnawing on her finger.
She giggles as she explains that she hadn't planned to get pregnant, then turns serious. "I was in denial. I was like, "No, I'm not pregnant. No, no, no. That can't be true.' And I just went like that till I was four months. I didn't know what to do. It was real hard." Her parents found out when she was five months along, and she was afraid they'd kick her out of the house. Then the father of her baby disappeared. "I thought I was gonna get married. He left." She pauses. "I don't know. He didn't want to marry me."
She was in her senior year and had been getting good grades, but she dropped out. And she stopped seeing her friends. "Right now I've got no friends. I don't want their parents to think, "Oh, she didn't get married. She had a baby. She's gonna make your boyfriend do the same thing to you.' I don't want them to think that about me." She says she doesn't go anywhere anymore. "I don't go to parties. I don't go out. I have to take care of my baby. But I don't have a problem with staying home. It doesn't matter." She smiles at Richard. "He will grow up, and we will go together."
She does most of the child care, though her parents and her new boyfriend help out. She says she didn't know anything about being a parent, but she doesn't want to raise her son the way she was raised. "I didn't used to like my parents. My father was always screaming, "I don't like this food.' He made me mad, because I make him the food and he never like it." She says her father is good with Richard, "but he loses his temper all the time. I don't know. He's gonna die like that. He's been like that all his life." She also says that because she didn't feel she could trust her parents when she was growing up, she wants Richard to be able to trust her. "I want to be a friend to my baby."
Asked what she expects of him, Ayala says, "I want him to respect me, be a good boy, a good son who'll obey me. I want him to go to school, be someone who can give a good example of us, of our heritage--we're from Mexico. And I don't want him to be a gangbanger." She's afraid to let Richard grow up in her neighborhood and thinks about sending him back to Mexico with her mother. "But not right now. If I see that he's in trouble, like if he's with bad friends, I will have to send him or go on my own."
Having Richard made Ayala start thinking about what she's going to do with her life, especially when she started going over her goals for him with Lopez. "They helped me think smart about going back to school and making something out of myself." She wants to be an immigration lawyer, and in July started classes so that she could get her GED. She would have gone back to school without Lopez's encouragement, she says, then smiles. "But maybe not so soon."
Asked what else she's learned from Lopez, Ayala first lists practical things like how to bathe and feed Richard properly. She says her parents used to spank her. "Mirian told me it wasn't good to do that to your son, because he might get to hate you. At first I didn't have patience with him because he used to cry so much. I didn't know that my baby was going to be so needy--I have to be all the time with him, because he doesn't like to be alone. But she taught me how to know what he needs, how to recognize the way he cries, because he cries differently. If he cries because he's bored, I have to play with him. When he starts to "aw, aw,' it's because he's hungry."
She says she would have been much more frustrated if she hadn't been shown how to read her son's cues. "I lose my temper sometimes, but I control myself. Mirian gave me good thoughts. She told me to think that the baby doesn't know how to talk, so I have to really think of what he needs."
Jacqueline Nieves, who's 22, has been in the program since her daughter, Jazeity, was born five months ago. Nieves, who has spent a lot of time looking after her nieces and nephews, does most of the caring for Jazeity, but her mother and Nieves's husband of nine months, David, help; they all live together in an apartment on North Western. Her father recently went back to Puerto Rico, where he'd been living until a year ago, when he came to Chicago for the funeral of one of his sons.
"I had good parents," Nieves says. "My mom and dad, they always wanted to give us the best of what they could. They were really strict, and I was scared to come to them about many things--I would deal with them on my own or see a counselor or something. They never spanked us or anything. They were strict on where we could go. We always had to be accompanied by an adult. But now as I'm growing up I see why they did it, because there's so many rapes and murders and everything."
Though Jazeity was planned, Nieves didn't tell her parents about her pregnancy right away. "I was scared. I was thinking, "Oh God, am I going to upset them?' But it was like so different. They were so understanding. I used to think, they're not going to love my baby, they're not going to want her. To my surprise, they adore my child."
She talks rapidly, confidently, about what she's learned from Lopez. "I've learned how to deal with my baby and to notice what little things bother her, what little things give her pleasure, how to comfort her when she's crying. Mirian has taught me about ear infections, about how important immunizations are. She has taught about how important it is to hold Jazeity, and when she needs to be held. And not to just prop the bottle on her, but to always hold her. And how important it is to have the family together--not only me taking care of her, but her father. Some women nowadays really don't see the father figure's role in the baby's life as important, but it needs to feel the love of both parents.
"She opens my eyes. We just finished this textbook she gave me. It's got all kinds of stuff--how to deal with your baby in the middle of the night when it's crying. It tells you the consequences of diaper rashes. And how to deal with the baby when it's growing up, how to deal with temper tantrums, spoiling your child--that's what we're working on now. I didn't know that you couldn't spoil the newborn or a young child. But she was telling me that there's no such thing, that if the baby cries it's because there's something wrong with it, and always respond to it. A baby from newborn to its first year really needs all the attention it can get--and I didn't know that. She went over dealing with the baby's stress. You don't think about babies having stress, but they do. That was something new to me, because I'm like, what would she have to worry about?" She laughs. "But when you think about it, she's got a lot to worry about. Everything's new to her."
Nieves says that her doctor and Lopez showed her how to stimulate Jazeity's curiosity by playing with a ball in front of her, by showing her colors, by putting things where she'll have to reach for them. "I talk a lot to her. And I've ordered books for her, because I want to start reading her stories and stuff like that. And Mirian was telling me to develop her self-esteem now, so that when she starts growing up she won't fear anything and she'll have an attitude like "I know I can do this' and she won't feel shy. Mirian says always praise her when she does something, like when she looks up or she turns around say, 'Wow, that was good.'"
Nieves isn't sure that she would have figured these things out on her own. "I was like, wow, you know? I didn't think about that. I might have done it, but I wouldn't have seen it in that sense. Mirian, she gave me that awareness. It's not that I like Jazeity better, because I adore my baby. That's just something you naturally have. But Mirian has woken up that--she has put an alert on what Jazeity really needs, and always be looking out for the little things."
Jazeity has been asleep in her crib, but suddenly she lets out a single, barely audible cry. Nieves jumps up and gets her. She settles the baby on her lap, smiling at her, kissing her hair, her fingers, her cheeks.
"I've always said that I want to provide my child with the best of everything to the best of my ability. I don't want to spoil her, but I want to give her some of the opportunities I didn't have--and some of the ones I did, but to a greater extent. I'm really focusing on her education. I still want to finish college--I'm most interested in child psychology--but I want my child to go way ahead of that. I want her to get farther than I did. I want her to be independent, which I wasn't able to do living with my parents, because they were really scared. There's going to be rules that I'm going to set for her that are going to be reasonable and I'll expect her to abide by, but I want to give her a sense of being able to take care of herself and not be dependent on anyone. I want her to have an open mind about everything--and to make the right decisions. And I want her to have that trust in me and to see me as her friend."
David comes home from work, kisses Jacqueline, lifts Jazeity from her lap, and disappears with her into the kitchen. "He spends a lot of time with her. He plays with her, he feeds her, he responds to her needs. He's really protective too. He's not able to be here when Mirian comes, so I have the books to refer to. He's not left out, because I fill him--and my mom--in on everything."
Nieves seems so upbeat about her daughter, her family, her future that it's hard to imagine how she got into the program. When Lopez is asked why, she simply smiles and says, "We did an assessment, and she qualified."
Ayala and Nieves are two of Lopez's stars, but she says that she's seen almost all of her clients become more independent, more in control of their lives. "I am proud to say that most of my girls are either finishing or have finished school. I've had two high school graduates, and two that are moving on to college. One is already employed, another one is employed part-time." Three have gone back to get their GEDs.
Vazquez says she's seen similar changes in the other home visitors' clients. "I've been really impressed with our clients' ability to get employment, though it's too soon to tell how long-lasting that employment will be." She says she's also been glad to see some of the young women moving out of abusive homes or breaking up with abusive boyfriends. "People don't always know what their options are before you show them. 'Can I really do this?' Sometimes people just need permission, for us to say, 'It's OK. Go for it.'"
Lopez sees changes in these clients too, even if they're limited. One night a relative of a client called to say that the young woman's live-in boyfriend was hitting her while she was holding her baby. Lopez called DCFS, but the agency couldn't send someone out because Lopez hadn't seen the incident herself. So she drove over and told the woman that if she wanted to stay in an abusive relationship that was her choice, but she had no right to endanger her baby. Lopez also explained that the woman could lose custody if DCFS got involved. Later that night Lopez overheard the woman telling her boyfriend that she was moving back in with her mother, that she wasn't going to lose her baby because of him. And she did move out.
This summer the father of the baby of another client was arrested for murder. "I went to visit her last week, and she was very upset. She said, 'I don't know how many years he's going to be in--and my baby's going to grow up without seeing his daddy.' Although they weren't together as a couple, he was starting to bond with the baby. And that was very important to her, because it took him a little while to take responsibility and say, 'Oh, this baby belongs to me. This is part of me.'" But the woman is doing well with the baby on her own and is starting college this fall.
Another client's mother recently told her that she was moving and didn't want to be responsible for her daughter or baby anymore. "So she's in danger of becoming homeless," says Lopez. "But I'm there for her, you see? 'Let's make a plan in case your mom decides to move next month. What are you going to do? Do you have someone that can take care of you while you get your life together?' What happens is she comes up with all these unrealistic solutions. 'Oh, I'll get a job. I'll find an apartment.' 'But how much money do you have saved?' Then she has time to reflect and say, 'Wow, if my mom moves out tomorrow I'll be out in the street.' 'Well, you know what? You won't be out in the street, because we can take you and your baby to a shelter.'"
Lopez has also had clients with so many problems that nothing she did seemed to help. "You say, God, what can I do to help this client get out of the situation? Because the client truly believes: this is my lifestyle, this is how I've been raised, and this is how I'm going to raise my child. You have to do more than you would normally do. Sometimes you need to focus more on the negative effects of spanking and what to do instead, setting limits with your children. You need to focus on abuse, talk about it all the time--what to do with stress, how to handle anger. You have to take classes to them, because they don't want to come to you. You offer to provide them with transportation, and it's, "Oh, no.' They sleep late or whatever.
"It's like they have no interest. You feel sometimes like, 'What am I doing wrong? Why am I not getting to this client like I've gotten to the rest of my clients?' It's just the family environment. Sometimes you feel, I don't need to be here--intervention needs to be here. Because it's just so difficult it becomes overwhelming. You say, wow, I want to save her from this. And you save her from this--and then here's this problem, and here's this other big problem. It's just a never-ending thing."
A dozen clients have begun the Healthy Families program and then dropped out, though nearly all of them simply moved beyond the program's boundaries. But Vazquez says they had to call DCFS on one woman, who then told them that she'd had enough of social-service agencies and wanted them all out of her life. "We tried to explain to her that DCFS is not an agency that she can say no to, I don't want you in my life anymore, and that it would be to her advantage to have somebody on her side. But she didn't see it that way." And Cheryl, the pregnant woman who yelled at her niece in front of Lopez, told Lopez late in the summer that she was going to drop out as soon as she had her baby. She said she didn't need any help learning to be a parent, because she was already doing a lot to raise her niece.
Still, Lopez says that she sees changes in even her toughest cases, though they may be difficult to measure. "Changes that are hardly noticeable--but they are changes. Let's say their immunizations are up to date--because of prompting, they've taken their baby to the doctor. But they did it. I mean, those are accomplishments. They're small, but they're important."
Art accompanying story in printed newspaper (not available in this archive): photos/Cynthia Howe.