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Most mental health professionals do not typically deal with firesetting behavior. They may not even be aware that a client is engaging in such behavior. If they are aware, it may be considered just one of many activities in a constellation of maladaptive behaviors, and therefore not specifically treated. Furthermore, mental health professionals have not historically received systematic training concerning firesetting.
Pathological firesetting is likely to continue if the underlying motivations or reinforcers are not specifically identified and treated. The following highlights critical assessment strategies for juvenile firesetters, as well as appropriate treatment issues.
As outlined in the dynamic-behavioral model, the particulars of the firesetting incident are critical in determining the type of firesetter and prioritizing interventions. Careful attention to the antecedents of the fire, the fire itself, and child and parent responses is essential. Details regarding the location of the fire, what was burned, who was there, the method of starting the fire, and how the materials used to ignite the fire were obtained will all help to determine primary motivation and future risk.
Forms have been devised to assist with this task. Fineman (1995) has developed forms--specifically for mental health and fire-service professionals--based on the dynamic-behavioral model. Other practitioners, such as Kolko and Kazdin (1994), also have devised forms to assist in the assessment of the child, family, and fire event(s).
The fire department also can provide assistance in the intervention process through well-targeted fire-safety education. Regardless of the seriousness of the fire incident or motivation, fire-safety education must be part of any intervention. (If the referral to the mental health professional originated with the fire department, fire-safety training may have already been conducted.)
The educational aspect of the intervention should be appropriate to the juvenile's developmental level. Fire-safety materials should address the nature of life, how rapidly it spreads, and its potential destructiveness, because firesetting adolescents do not necessarily understand the repercussions of their behavior. Appropriate responses to emergencies also should be taught, such as knowing the best ways out of a building when there is a fire. Parents need to be included in this process, with emphasis on safe storage of materials that can ignite a fire, proper supervision, and the importance of not allowing children to use fire until they are capable of understanding the responsibility involved.
Mental health interventions are of maximum effectiveness when a flexible, team approach is implemented. Due to the often chaotic nature of households with a juvenile firesetter, the traditional medical model of therapy is not generally sufficient. Instead, an outreach model is helpful in connecting families with outside services, as well as encouraging follow-through. Case management is important for interagency coordination.
Practitioners indicate that they do not see many firesetters from economically challenged families because of the limited funding for mental health services. In order for juvenile firesetters from all socioeconomic backgrounds to receive treatment, it is recommended that state fire marshals help develop and sponsor programs that follow the fire intervention mentor model (FIMM). This model calls for the training of key mental health personnel in the treatment of firesetters. These "mentors" then train and supervise others (sometimes by phone and e-mail) at no or reduced cost. Thus, families that "fall between the cracks" because of lack of funding could receive treatment from any number of qualified mental health personnel.
Treatment for firesetting may require inpatient care. Placement would depend on the level of risk for continued firesetting and the family's ability to provide support and structure.
As described in the dynamic-behavioral model, firesetting involves the interaction of individual, social, and environmental factors. It is critical that the juvenile understand this interaction in order to begin to recognize the circumstances and emotions that lead to firesetting. Establishing the links to firesetting enables emotions, thoughts, and behaviors to be redirected to healthier choices.
Bumpass and colleagues (1983) have developed a charting technique by which the juvenile can concretely visualize the events and feelings leading up to firesetting. Events and feelings, in chronological order, are recorded along the X-axis, with the magnitude of the emotion indicated along the Y-axis. Once the juvenile and parents understand and can identify components of this sequence, alternative responses and behaviors can be explored. In a study of 29 patients treated with this method, Bumpass et al. (1983) reported that only two set subsequent fires. Follow-up periods were from 6 months to 8 years, with an average of 2 1/2 years.
Existing approaches to psychotherapy should be applied in accordance with the specific type of firesetter. For the cry-for-help type, there is usually a serious deficit in family communication skills. Emphasis should therefore be on developing more adaptive ways of expressing feelings and frustrations. Aggression replacement training or anger management skills help juveniles express anger in more socially acceptable ways. Social skills training is also useful in this regard.
Adolescents who resort to firesetting to bring attention to difficult situations often do so because they feel powerless. Very often, they simply cannot think of anything else to do. These adolescents and their families demonstrate poor problem-solving skills. In such cases, instruction in decision-making and problem-solving techniques may be effective. In addition, assertiveness training may be an important treatment component, giving the firesetter a "voice" in family or peer group interactions.
For example, one program uses a seven-step problem-solving technique (Ritchey & Janekowski, 1989): (1) define the problem, (2) brainstorm possible solutions or alternatives, (3) evaluate the solutions or alternatives, (4) select a solution, (5) plan the implementation, (6) try it, and (7) evaluate the effectiveness of the plan. Families are taught to follow each step and are provided practice in working out problems together.
In sum, the successful treatment of adolescent firesetters is multifaceted. Behavioral, emotional, cognitive, and familial factors must be analyzed, and the category to which a firesetter belongs must be determined. The firesetting sequence should be made clear. Recidivism risk needs to be addressed. The appropriate intervention, from short-term counseling, day-treatment programs, inpatient hospitalization, to residential treatment programs, has to be selected. Finally, partnering mental health personnel with fire-safety experts can provide cost-effective benefits for the entire community.
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