Established across North America in the opening decades of the twentieth century, guidance clinics were part of an international trend in channeling resources towards preventative measures, indicating a move away from biological reductionist understandings of mental deficiency and towards considerations for environmental factors. The clinics aimed to assist individuals, predominately children, in adjusting to their surroundings and more generally to society, with the intention of preventing serious mental illnesses. In Western Canada, where Alberta and British Columbia maintained eugenics programs, they also served to direct children with mental deficiencies towards sexual sterilization. Despite receiving only passing mention in the secondary literature, 32% of the total number of cases presented to the Alberta Eugenic Board had contact with a guidance clinic prior to being presented before the Board, with the majority of clinic cases being referred to the clinics through the province’s schools.

Institutionalization and sterilization
Following the enactment of the Sexual Sterilization Act of Alberta in 1928, guidance clinics were established in Edmonton, Calgary, and Lethbridge in 1929 and quickly expanded to other areas throughout the province. In rural Alberta, rather than being set up on a full time basis, they operated as traveling clinics, and were often held in the schools, or in the office of the resident public health nurse. Individuals referred to these clinics received physical, psychiatric, and in some cases psychometric or IQ examinations. Recommendations were made based on these evaluations, which in instances of “mental deficiency” included “sterilization and supervision,” “medical and surgical treatment,” “modified school work,” “special class at school,” “placement in a good home,” “deportation,” and “institutional training and care.” When institutionalization was deemed unnecessary by the clinic staff, the patient, parent, or guardian, and often the teaching personnel were advised on how to deal with the case in the home or community.

The Alberta government saw the guidance clinics as an opportunity to reduce the costs associated with psychiatric institutionalization by pre-screening potential patients before they were admitted to one of the province’s institutions, such as the Provincial Training School in Red Deer. Additionally, the clinics provided a way to supervise people considered mentally defective more closely, and to provide the institutions with more background information on patients, something that was becoming increasingly important as environmental considerations were gaining traction. By the time that the Provincial Training School had become an important feeder institution to the eugenics program in 1940s, the majority of trainees it admitted each year came through the provincial guidance clinics.

Amendments to the Sexual Sterilization Act and the Guidance Clinics
Alberta’s sexual sterilization legislation was amended on two occasions, once in 1937 and again in 1942; the first amendment particularly, served to expand the program beyond the province’s psychiatric institutions. Importantly, the 1937 amendment formally allowed the guidance clinics to present cases directly to the Eugenics Board as “outpatients,” thereby creating a path to the Board from outside the provincial psychiatric institutions and training school. Following this amendment, the guidance clinics became critical to the provincial eugenics program.

The Alberta Department of Public Health employed overlapping personnel between the guidance clinics, provincial psychiatric institutions, and Eugenics Board. From the beginning, these clinics were under the direction of the same individuals who were in charge of the provincial psychiatric institutions and training school. It was also common practice for a social worker to concurrently hold the positions of Secretary to the Eugenics Board and Chief Psychiatric Social Worker, which was the position responsible for the guidance clinic service. Therefore, those individuals directly in charge of the province’s guidance clinics had a vested interest in the clinics contributing to the eugenics program. The clinics represented the movement of mental health experts, the provincial psychiatric institutions, training schools, and, with the 1937 amendment, the Eugenics Board into the community with the help of professionals who were already working on the ground.

Conclusion
Guidance clinics provided a variety of professionals, particularly those engaged in child welfare work, with a way to engage with the new sciences of eugenics and mental hygiene outside the formal setting of a psychiatric institution or training school. Their role in referring individuals to the clinics, collecting case histories, interpreting clinic recommendations for families, and ensuring that such recommendations were being followed, made these professionals critical to the daily operation of the provincial eugenics program. This was particularly true after the 1937 amendment. The amendment, by establishing guidance clinics as feeder-institutions to the Eugenics Board, served to further entrench the sterilization program in provincial schools, and public health and welfare services.

-Amy Samson

• Gleason, Mona. (1999). Normalizing the Ideal: Psychology, Schooling, and the Family in Postwar Canada . Toronto: University of Toronto Press.

• Jones, Kathleen W. (1999). aming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority . Cambridge, Massachusetts: Harvard University Press.

• Samson, Amy. (2014). “Eugenics in the Community: Gendered Professions and Eugenic Sterilization in Alberta, 1928-1972.” Canadian Bulletin of Medical History 31(1): 143-164.

• Samson, Amy. (2014). Eugenics in the Community: The United Farm Women of Alberta, Public Health Nursing, Teaching, Social Work, and Sexual Sterilization in Alberta, 1928-1972. PhD Dissertation, University of Saskatchewan.