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ISSN 0840-982X



Table of contents

Editorial: On the Fear of Contact, the Need for Touch, and Creating Youth Care Contexts Where Touching is Okay / Thom Garfat

1    Sanctioning Violence in Parenting: Canada's Ongoing Discrimination Against Children / Tammy Schilbe

15    Child and Youth Care Work in Schools: The Tale of Four Widgets / Duane K. Seibel

27    Therapeutic Application of Play / Don Pazaratz

39    Injuries and Illness in a Residential Care Setting and Their Implications for First Aid Training / Donovan Hoggan

45    The Healthful Effects of Laughter / Christine Puder

55    Educating Toward Awareness: Self-Awareness in Ethical Decision-Making for Child and Youth Care Workers / Iris Elsdon

69    Fundamental Processes for Interventions: Working with High-Risk Adolescents and Their Families / Mary Ballantyne, Grant Macdonald, and Leslie Raymond


In this issue

Vol 12(3)

Children are our most important resource. Youth are the caretakers of tomorrow. In these and other platitudes we sing the praise of youth. But how do we treat young people when writing laws in this country? In Sanctioning Violence in Parenting: Canada's Ongoing Discrimination Against Children, Tammy Schilbe challenges these platitudes through an examination of how we fail to protect children and youth from legally sanctioned violence. It is a political and provocative read.

We often hear reference to school-based youth care work, but those of us who work in other environments wonder about some things. Who, for example, is the school-based child and youth care worker? 'What does this worker do? How are widgets relevant? These questions are answered by Duane Seibel in Child and Youth Care Work in Schools: The Tale of Four Widgets, based on his master's research in British Columbia. Are the results relevant to other locations? Ah, there's another question for someone else to answer.

Young people play all the time. It is part of human nature. But do we play with them enough ourselves? And why would we? What would be the purpose of doing so? In his article, Therapeutic Application of Play, Don Pazaratz attempts to answer these and a few other questions through a case example of his work using play and playfulness.

How frequently do young people in care, or staff, get hurt or become ill? And what kind of illness and/or injury do they experience? Knowing the answer to these questions could help us to determine what raining staff need. In Injuries and Illness in a Residential Care Setting and Their Implications for First Aid Training, Donovan Hoggan sets out to find an answer to these questions in his own setting. As well as offering some interesting information, this article demonstrates how simple in-house research projects can help to answer important questions about where and how our resources should be distributed.

As well as playing, we should learn to laugh with young people and their families. In her article, The Healthful Effects of Laughter, Christine Puder helps us to understand a little more about how laughter is a therapeutic influence on people.

Self-awareness is commonly cited as an essential element of effective youth care practice. In Educating Toward Awareness: Self Awareness in Ethical Decision-Making for Child and Youth Care Workers, Iris Elsdon argues for the importance of including self-awareness training as part of the basic education for child and youth care workers. Her article is also a nice example of drawing from current experiencing to develop theory and recommendations.

Across the country child and youth care workers are being asked (and demanding) to be involved with families. In Fundamental Processes for Interventions: Working with High-Risk Adolescents and their Families, Mary Ballantyne, Grant Macdonald, and Leslie Raymond highlight some of the essential characteristics necessary for workers to be effective in this area. Once again, relationship, the essence of effective youth care practice, takes centre stage.

In Travels with My Unit, Garth Goodwin offers some timely advice for those of us thinking about undertaking a voyage with the youth in our care. It also points out some of the potential value of such an activity.

We also include our regular features: Ask Charlotte, Views from the Field, and Journal Entries.


On the Fear of Contact, the Need for Touch, and Creating Youth Care Contexts Where Touching is Okay

Thom Garfat, PhD.

All across this country youth who live in group care, and many others involved in professional relationships with youth care workers, are being deprived of a basic human necessity � physical contact. As the years have gone on, and the incidents and accusations have mounted, youth care workers in group homes, residential centres, schools, and other care-giving programs have begun to move away, physically, from the youth in their care.

Fear seems to drive us; fear of accusations, fear of losing our employment, fear of having to give up this work that we love. I understand that fear. Many of us have colleagues who have been dragged in to the quagmire of accusations about inappropriate touch. So we become afraid, back away, and withhold. We back away from the youth and withhold the most basic human experience, the experience of being touched by another person.

I want to make a distinction here: between those who would touch youth in the most normal and healthy of ways; a pat on the back, a touch on the shoulder, a comforting hug when the world is a difficult place, a hand held in a moment of crisis, and those who use the opportunity to touch a young person as an opportunity to satisfy their own needs and desires. Like many of you, I have no patience for those who use children and youth for their own gain, to satisfy some obnoxious need that they cannot meet in a healthy manner in their own lives. This isn't about them. This is about us, you and I, and our colleagues who are in this work for the right reasons, not to satisfy the needs we can't meet in the other, personal, areas of our lives. This is about the healthy majority, those who care for children and youth because it is the right thing to do, because it is part of what makes us human, draws us to this field and ultimately gives us the satisfaction of feeling that we have made a contribution to the lives of others.

How the world has changed. Ten years ago I would not have even felt the necessity to make that distinction. But we have become so afraid, so paranoid (dare I use the word) about others mis-interpreting our meaning in this area of physical contact that I feel these days, the need to be careful. To make sure. To be safe. And it seems wrong to me that I should have to do this. But this feeling is rampant in our work.

Look around you. See the political safety and the paranoia in action. Additional staffing so that staff of one gender aren't alone in a unit with youth of a different gender. Hugs from the side. Conversations with the doors open. People asking permission of other people to touch them on the shoulder. Children pushed back when they reach out for the most basic thing, human physical contact.

Soon we will be running around the units, schools, and family homes in space age contamination suits. Our sight will be shielded by blinders like an old work horse trudging through the fields. Our every move monitored by cameras. Acceptable distances for appropriate interactions will be detailed in policy manuals. Conversational words will be chosen from a list on the wall. Touch will be filtered through a sense-denying rubber glove.

The contact of human flesh, because it is forbidden, will become another of the taboos, sought after, not because it is normal, but because it is forbidden. Youth will sneak off in to corners to touch flesh � even just hand to hand � the way they sneak off to smoke, drink, or engage in conversations which are offensive to their caretakers. By forbidding something we make it mysterious, an object of curiosity, attractive.

We have to stop this nonsense.

I know there is a danger in what I am saying. Some of you will think I am off the wall, advocating the return of touch to our work. Some of you, perverted in some unexplainable way, may take this as permission to satisfy your needs by touching inappropriately. But can we all be led by the devil in our midst? Must all of our behavior be shaped by the worst among us? Does control of this basic human element of relationship have to be left in the hands of those who are evil in their intentions?

Must all children and youth suffer, because there are a few inappropriate people in our profession? Must all youth be denied contact because a few have mis-used their power or position? Because that seems to be what we are in danger of doing.

It seems to me that we are tackling this problem in the easy way and it is causing us problems. Rather than taking on the challenge directly and weeding out those who are inappropriate, rather than developing pro-active, positive training which protects the staff and meet the needs of youth, rather than taking our responsibility seriously, we have chosen the easiest route. We have chosen the route of rules which forbid, regulations which make it easy for incompetent supervisors, staff who are afraid to confront one another, schools which are unable to teach, trainers who shy away from the tough questions, and books that avoid.

Especially, we make rules. Rules which cause us to ignore the needs of children and youth. Rules which make it easy for management to set simple expectations. And this is the easy way out. Setting the expectation �don�t� is always easier that setting, and ensuring, the expectation `do'. Because there is no �how� in �don�t�.

We are in the business of caring for troubled children and youth. This is what we have chosen to do. This is what is expected of us: to care for troubled children and youth. Let me ask a simple question.

Have you ever been in a caring relationship that didn't involve some form of touch? If touch was absent and a person said they cared, could you believe it, unless that touch was restricted by a physical characteristic on one of the partners to the relationship?

I was in a workshop the other day and a mother told the following story.

My daughter was having trouble in school when she was only six years old. All year long she told me how she didn't feel good about her teacher. They never seemed to connect and much as I would try, going to meetings, asking the teacher what was going on, we weren't able to figure out what was wrong. Finally the year ended and we looked forward to another teacher and another opportunity.

Summer progressed. One day my daughter came to me and said �I know what was wrong with my teacher last year�. I listened curiously, aware that she had obviously been thinking about this for some time.

�All year long,� she said, �he never touched me. Not once. I thought he didn't like me.�

And this from a six year old child.

We all need to be touched. It is part of being human. It is part of how we form attachments. It is part of how we, as a race of people, express caring. It is one of the ways in which we say to another person `you are of value, you are important, you are worthy of being cared for'. It is a part of our culture and the reality of the world we live in. I could quote to you the studies but you already know that this is true. Besides, you've read the literature about the importance of human touch in facilitating development, about the feeling of isolation and rejection which people experience when touch is withheld, about how touch is a necessary component in developing experiences of attachment or, about how touch is one of the ways in which we experience �connectedness� with one another.

So, what are we doing? Why are we insisting in behaving in a manner that we know is contrary to the growth and development of the youth in our care? Because we are afraid? Because we are unable or unwilling to do our job? Because we don't know what else to do?

There is another way. A way that protects children from the inappropriate among us and still meets their needs. A way that protects staff and still meets the needs of those in our care. There is a better way, but it requires courage.

One of our major tasks is to create environments of safety and security for young people; environments of trust within which they can learn to relax, let go of their fear, discover new possibilities for being in relationship and move on to a different phase of their life, hopefully with less pain and greater confidence. So, lets start there. Let's create environments of trust where they, and we, can feel assured that young people will be treated with dignity and respect and not have to worry about someone taking advantage of them. Let's create environments where we can be assured that touch is about health, not abuse. Let's take our responsibility seriously. How? In no particular order, here are a few ideas.

1. Hire people who can be trusted to be with young people. 
There are tools available to help us do this. It means, of course, that all new employees have to be carefully screened. There are child abuse potential tests, police checks, hiring procedures that select in people with the characteristics associated with being good youth care workers, psychological tests which screen out people who have difficulty with power and power in relationships and, personality profiles which pinpoint people with distorted views of people, youth and relationships. There are in-depth interviews which can be focused on who you are and how you are in relationship rather than where you went to school, where you worked, and what you know theoretically. And finally, take reference checks seriously. Ask difficult questions of the person making the reference, like were there ever times when s/he struggled with issues of power in relationship with youth or; when personal business and needs came up, what did the staff person do? Trust and the therapeutic relationship go hand in hand; both are essential components of effective youth care work. Youth need to be able to trust the people who are working with them and to feel confident that trust will not be violated. The characteristic of `being trustworthy' belongs in the hiring process. Screening people in to, or out of, the field does not guarantee the safety of youth. It is not enough to implement screening and then just sit back and say �Oh, All our staff are screened�. It does not provide another easy way out for those who would not take other measures. It is not the escape from responsibility some would make it appear. It is only one piece of the solution, not the solution itself.

2. Provide appropriate supervision, both scheduled and on-the-floor. 
Supervision lets the supervisor know how the staff are being in relationship with young people and this has to be the most important element. After all, most inappropriate touch happens in the context of a relationship, and �in relationship� is where we see the elements on the inappropriate use of power, the deference or compliance of youth, and the distortion of boundaries between young people and workers. This supervision, however, cannot just be of the common garden variety taking place behind closed doors away from the relationship between youth and workers. It must also be of the �on-the-floor�, �while they are interacting� variety where the supervisor actually sees what is going on, not just hears about it screened through the experiential frame of the worker. Appropriate supervision provides an additional set of eyes watching what is going on between youth and staff; sometimes in the morning, sometimes in the day; and sometimes late in to the night. But supervision does more than watch. It also provides support for the worker, a place to sort out the sometimes confusing experiences the worker has with the youth, a place to process feelings, thoughts, and actions. A place to check in, to be sure, to be safe. And a place for the supervisor to monitor the interactions between youth and staff. Supervision and safety go hand in hand.

3. Have a zero tolerance policy with regard to disrespect. 
Disrespect is not just about abuse. Respect or disrespect is in the little things, like labeling, disregarding opinions, being inappropriately abrupt in responding to someone, or not seeking input. Disrespect is about power. It is about whether or not we believe that �other� has power in this relationship. When staff treat youth with disrespect, they signal to the youth that the youth is of no value, or only as much value as the �dis-respecter� cares to award to the youth. In our work with young people we should tolerate no disrespect towards the youth. They have frequently come from worlds in which they were de-valued, or disrespected, on a daily basis. We don't want to continue this experience for them. It is contrary to the very purpose of our work: healing. When people are hired in to this work, our expectations and guidelines should be made extremely clear, just as they are if someone is going to work in medicine, education or any other field. There are certain protocols which apply � if, for example, you are going to work in an operating room, there are clear expectations about dress, hygiene and performance and if you are going to work with youth, there are protocols regarding self, relationship and respect which apply. Once the guidelines are clear it is reasonable to expect people to follow them. If a person cannot find it in themselves to follow such guidelines, they should be working someplace else.

4. Create climates where youth speak up if they don't �feel good�. 
Young people in care sometimes speak of the group care environment, or relationships with helpers, as a place where �nobody listens anyway�. Sometimes young people talk of having tried to tell someone something difficult only to have the worker focus on some aspect of the form of communication rather than the content. If they aren�t being heard, why should they speak? We need to create environments of trust, support and the opportunity to be heard. It is not enough to say we listen. We must also have vehicles, formal and informal, for youth to communicate their concerns to us. Group meetings, individual conversations, complaint procedures, abuse reporting procedures, peer advocates: these are a few of the options available to us. And we need to make sure that youth and staff know how to use these resources; that they are clear, accessible and useful. We also have to be careful of a sometimes unfortunate tendency to disregard what youth have to say because the youth �is a liar� or has �made unproven accusations before�. Just because it was not proven last time, does not mean it did not happen this time. Each complaint needs to be reviewed in its own light. But most importantly, youth must know that someone is hearing what they have to say and the best way that I know of to create that experience is to do something when youth bring a concern to you. It doesn't have to be a big concern. It could be about the menu, the types of activities, their experiences at work, their concerns about another youth, feelings about how they are treated at school. We start with the `everyday'. Once youth experience us as listening to their everyday concerns, they may come to think we will listen about the other, bigger things; like not feeling good or safe with someone on staff.

5. Teach staff how to read, respect, and respond to feedback from touches. 
Feedback is all around us. It is in the little things that people do: how they move; the look on their faces; the slight hesitations in their speech. Unfortunately, we don�t always pay close attention and, even when we do, we often assume that we know what is going on, what is meant by the feedback we experience. Seeing the feedback, for example, is one thing. It simply requires that we be observant and know what we are looking for. Respecting it, however, means that we must be interpreting it accurately. And that requires help in interpretation; help from the person who is giving the feedback. So, one of the things people need to know how to do, is how to ask for help in interpreting the feedback. Like when I touch a youth and the youth shies away. If I don�t ask for the youth for help in interpretation I might assume the youth is frightened, or shy, or physically uncomfortable, or any one of a number of things. When I ask for help in interpreting the reaction, however, I may come closer in my understanding of the meaning of the youth's action. Once I am confident that my interpretation of the feedback is more accurate, I am in a position to respond to the real meaning of the feedback, not just my own speculation about what it means. The bonus to this approach of checking out meaning, is that youth may come to realize that you care about what they experience, and what their experience means. This, in turn, opens up the door for more difficult discussions and sets the stage for you to be wondering with them, what their behavior means. Finally, if a youth seems to express an avoidance to being around a certain person, we need to ask why.

6. Make psychological safety and security a priority for staff and youth. 
Often in working with troubled youth we talk about our concern for the safety of the youth. Usually, when we do, we are talking abut the physical safety of the young people. And if someone working with the youth was to expose the youth to physical danger, we would be quick to respond because of how we have prioritized physical safety as a concern. We need to put psychological safety in the same place on our list or priorities. Change that policy line from �the physical safety of young people� to �the physical and psychological safety and security of young people�. Once psychological security becomes a high priority, then we will become more focused on it in out work. And this alone will help to create a safer environment, psychologically as well as physically.

7. Be careful of which staff needs are not being met in relationships with youth. 
We all have our own needs. We all work to have our needs met. Most of our needs are met in the context of relationships with others. We need to ensure that the people working with youth know that there is the danger that they will use their relationships with young people to satisfy their own needs. We need to help staff be self-aware enough to recognize their own needs and when they are trying to have those needs met. And then we need to help them to understand how this might happen in their relationships with young people and what they should do if they notice this in their work. Part of a supervisor's role is to help people reflect on why they are doing what they are doing, and that includes paying attention to need-meeting behaviors. I know that we are all meeting our own needs in working with young people and their families: the need to be helpful; the need to feel that our lives are meaningful and; the need to care for others, for example. This is normal and even healthy. It is how these needs are met that is important. And of course, we must be concerned about staff meeting other, less healthy, needs in their relationships with youth. The caring and treatment for troubled youth is about meeting youths' needs, not the needs of staff. This, and this alone, should be our primary goal.

8. Teach people to touch appropriately. 
There are such things as �good touch and bad touch� and everyone, both staff and young people, need to be able to make this distinction. We need to spend time educating everyone about the difference so that we all have a common reference point when having discussions about what is appropriate and what is not. As well, we need to remember that not everyone likes to be touched in the same way. Not all gestures are interpreted in the same way by different people. Some people enter in to relationships without taking the time to discriminate how things, like touch, have different meanings to different people. Part of touching appropriately, is touching in a discriminate manner. Part of touching therapeutically, is also knowing when not to touch.

9. Hold each other accountable. 
I don't know why it is that we seem so hesitant to confront one another, to challenge the practices of one another or to simply intervene when we feel that one of our team mates is being inappropriate. I don't mean confrontation about the really big things. I mean with the little things, the things that are the precursors to inappropriate touching. Like violating boundaries or misusing power or simply being verbally inappropriate with youth. I believe that if we were to hold one another accountable our programs would be a safer place for children and youth. Really, if you think about it, every time we fail to confront a colleague who is doing something which is not in the best interests of the child we contribute to the creation of inappropriate, and possibly abusive, environments. So, we have an ethical and a moral responsibility to monitor, and provide feedback on, the performance of our colleagues and to accept their feedback on ours. Every time we avoid a confrontation that is necessary, we send a message that the inappropriate behavior is okay.

10. Eliminate people who don�t feel right. 
Now there is a thought destined to strike fear in to the hearts of those afraid to do their jobs. No. No. Don't tell me why it is impossible. I�ve worked in those environments for over twenty-five years and I know that, if it is truly in the best interests of children and youth, it can be done. I had a mentor once who said �if that person shouldn't be with children and you don�t get them to leave, you are responsible for whatever follows�. Who would want to wear that guilt? If the youth consistently don't feel good around someone, that person shouldn't be in the field. Unionized or not, people who don�t feel good to youth shouldn't have the opportunity to work with them.

I know that the foregoing is not going to eliminate all the incidences of inappropriate touching, but it will help to create safer environments for youth and staff. Youth will feel safer and staff will feel more secure. And if we all feel a little more safe and secure, we can all begin to relax a little, and we can make sure that what we eliminate from the field is only inappropriate touch, not all touching.

Remember, touch is part of human nature, touch is developmentally necessary, touch is part of healing, touch is a form of communication and touch builds bridges. And remember what the little girl said:

�All year long he never touched me. Not once. I thought he didn�t like me.�