In this issue
Merrily Wolf,
Wanda Copeland, and Kimberly Nollan take us straight to
the "bread and butter" of child and youth care practice
with their article All in a Day's Work: Resources for Teaching
Life Skills. What we like about this paper is that it really
does offer a useful resource -- a tool that can be used to assess
and direct life skill activities. Whatever else we do, child and
youth care workers will always find ourselves teaching kids how to
manage life's everyday challenges.
Our second article, Cultural
and Other Factors Related to the Process of Emancipation from
Foster Care by Daniel Tovar and Harold Briggs,
deals with a timely topic that has received relatively little
attention. Although the paper draws its examples from the U.S.
scene, the issues the authors raise have international relevance.
There are few places these days where CYC practitioners are not
dealing with young people constantly moving in and out of foster
care placements, and the cultural implications are becoming
increasingly apparent.
Still on the topic of
cultural diversity, Louise Underwood (Thulih-wul-wut),
an Elder and Chief with the Cowichan Tribes, and Bruce
Cooke-Dallin collaborate in an article titled Child
and Youth Care Education for First Nations Students: The
Contribution of Elders. These educators are justifiably proud
of the work being done at Malaspina University-College in bringing
culturally relevant programs to First Nations students. Perhaps
those of us who came to North America later can learn something
about tapping into the wisdom of those who have walked the paths
before us.
Wayne Pealo
actually does tap into this wisdom in his article Holistic
Lifestyles of Child and Youth Care Workers in the Cowichan Valley
Region. For some time now, Wayne has been specializing in the
area of wellness and health promotion within the same educational
setting. While his study might be modest, the issue he raises is
monumental: helper heal thyself.
Examining the Effects
of Prenatal Alcohol Exposure on the Development of Children and
Adolescents: An Eriksonian View by Wanda Polzin
is a thoughtful and thorough analysis of a very relevant topic. As
practitioners we need to be "educated' in this area but all
too often the available material is either too technical or too
abstract for our purposes. In our opinion, this article offers a
useful frame of reference, particularly if you happen to
appreciate an Eriksonian perspective. |
|
It was only a matter of
time before someone set out to explore the relationship between
the well-being of children and the work habits of their parents. Bryan
Robinson throws the door open with a highly informative
article, Children of Workaholics: What Practitioners Need to
Know, that encourages the reader to consider this issue
further. Whoever would have thought that hard work has a downside?
It's always encouraging
when practitioners taking their first professional steps
demonstrate the courage to share their perceptions with us.
Thankfully, CYC remains as open to the experience of the
"rookie" as well as the seasoned performer. Our thanks
to Dana Beresh for deciding to send along her
perceptions and thoughts on this weird and wonderful profession of
ours.
And so we say farewell to
our old friend Charlotte. And so she says farewell to us in this,
her final piece for the Journal. What can we say about
this whimsical woman of words? Bon voyage, my love.
In our Journal Entries
section we hear from our old friend Russel Milner,
who seems to come up with a contribution every few years. In this
piece he takes his own guilt trip and, as always, comes out
shining on the other side. Ardith Conlin takes us
into a new arena with a movie review from a CYC perspective.
Thanks to Ardith we have been reminded that movies (and TV)
constantly project images of kids and their relationships.
Sometimes we come away appalled, sometimes fascinated, and
sometimes enlightened. In this case, the reviewer demonstrates
that there is something to be revealed, even after The Full
Monty.
More traditionally, Carol
Matthews offers us her review of the book Cold New
World by William Finnegan. Sometimes a book review can be
more than a summary punctuated by judgments. We invite prospective
book reviewers to review this review. Finally our new Book Review
Editor Steve Bentheim discusses the texts As
If Kids Mattered by Marlene Webber and Peace in the
Streets: Breaking the Cycle of Gang Violence by Arturo
Hernandez. We look forward to more reviews from Steve. Please send
texts for review directly to Steve at the Journal of Child and
Youth Care. |
Editorial
The Medical Model is Alive and
Well
and Killing Child and Youth Care
Gerry Fewster, Ph.D.
A soft summer's evening. Through
careless obligation, I’m at a dinner party organized to raise funds
for a new mental health service. Through cruel destiny, I’m seated at
a table with a group of medical types — two GPs, a surgeon, a shrink
and a researcher specializing in some version of neurology. I’m
unusually quiet, sipping contentedly on a cheeky little local chardonnay
as they discuss the most recent stock market trends. Just as I stick my
finger in my vichyssoise, the conversation shifts to the new wonder
drugs that can massacre the symptoms of everything from Swine Flu to
Schizophrenia (a good investment for those with a few bucks to spare).
Again, I reserve the right to remain silent, waiting patiently (no pun
intended) for the host to deliver her specialty — baked salmon with
couscous. Deflecting the barrage of technicalities and brand names, I
discover that their major concern is that these drugs are not
sufficiently available to help the growing numbers of patients they are
now diagnosing with the most popular disorders. The price of my silence
is rising but, to preserve the integrity of the salmon, I assure myself
that I’m conducting my own research of the ethos of the medical
community. Inevitably, the conversation switches to the treatment of
their two favourite childhood diagnoses, Clinical Depression and
Attention Deficit Hyperactivity Disorder. I struggle to avoid
contaminating my study with profound, even hostile, observer bias but I
breathe and let them go on. Nobody expresses any curiosity about what
might be happening for the child beyond the offensive symptoms. Nobody
refers to research suggesting that these substances appear to work by
numbing out higher cognitive functioning. Nobody expresses any concern
about reports that in some North American schools, over fifty percent of
the students are on some form of psychotropic medication. Nobody
suggests that it might be the task of schools to respond to the needs of
kids rather than the other way around. Nobody mentions the growing
concerns about kids and families being coerced into using these
substances through threats ranging from the removal from school to
certification under mental health legislation. Nobody raises any
questions about why so many of these kids will end up dependent on other
drugs — legal and illegal. And, of course, nobody admits that they
have no idea about what this stuff actually does to the brain, either in
the short run or in the long run. Yet, here they are, arrogantly
congratulating each other and committing themselves to up the societal
dosage wherever and whenever possible. My mind runs back to a case
conference in 1972 when I had to be restrained from attempting to
disembowel our “team” psychiatrist with a letter opener after he
admitted giving eight series of ECT to a sad eleven year old girl —
“to treat her depression.” Now, older a wiser, on a soft summer’s
evening, I maintain my strategy of self-restraint, knowing that I’m
about to destroy whatever pleasure they may be anticipating for the
upcoming creme broullé.
Within our own profession
My purpose in telling this story is not to launch yet another attack
on medical practices. Let’s face it, prescribing medication is what
physicians and psychiatrists do — amen. Nor am I about to vilify the
pharmaceutical companies or their well-remunerated researchers. They are
in the business of selling their products and maximizing their profits,
just like all other commercial enterprises. I’m not even going to pass
judgment on those who support such practices with some version of
“doctor knows best” even when the sinister and destructive
consequences are staring them in the face. For the purposes of this
editorial, my concern is with Child and Youth Care, as a profession,
since it’s obvious to me that, along with other so-called
“helping” disciplines, we are saturated in the type of thinking and
methods that have become known as “the medical model.”
For the most part, Child and Youth Care Workers are concerned with the
elimination (treatment) of particular problems (symptoms) presented by
particular kids (patients). Most are educated and trained to see how
such symptoms come together (syndromes) within the context of particular
lives, families, groups and communities (etiology) while some are
involved in addressing the incidence and prevalence of specific problems
within a community (epidemiology). Whether they focus on normative
(normal), deviant (abnormal) or persistent (pathological) problems,
their concepts and theories are about fixing (curing) the identified
malady (disease), often regarding the client’s (patient’s) own
experience as being too subjective to be of value. However much they
might express a distaste for “labeling,” there is constant pressure
to produce assessment (diagnosis) methods for grouping kids according to
their symptom clusters linked to particular (treatment) approaches
(prescriptions). Some work in community (out-patient) programs, while
others work with the more serious “cases” in residential settings
(hospitals). Like their medical counterparts many come to regard the
“helping relationship” as a convenient oil can for lubricating their
preferred methodologies. Whether they regard themselves as
“generalists” or “specialists,” most want to be considered as
professionals, experts, defined by themselves and others for what they
do rather than for who they are. And, finally, they want their status
and their practices to be protected from usurpers and impostors through
academic qualifications and self-serving associations — professionals
all.
Okay, so I might be going too far with all this, but look around. Tune
into the international forum on the Internet (an excellent vehicle for
sharing CYC ideas and experiences) and consider the questions being
asked and the responses being given. Examine the curricula of Child and
Youth Care educational or training institutions and look at the theories
being taught and the methods being practiced. Attend any workshop or
conference and examine the content – particularly of the most popular
offerings and presentations. Purchase a complete set of the Journal of
Child and Youth Care (please) and review the articles – start by
scanning this issue. Go to any agency and ask them to describe their
philosophy, their goals and their programs. And behind it all, you will
find one pervasive ideology – if we use our specialized knowledge and
skills, we can solve people’s problems, fix their lives and made them
happy; all we need is your support, your respect and, of course, your
money.
Unattainable goals
If you still consider my position to be overstated I would welcome
your comments. Meanwhile, I continue to believe that the so-called
medical model is an insidious trap that will always generate nothing but
frustration and futility for child and youth care workers and arrest the
development of the profession as a whole. The underlying problem is that
the goals are simply unattainable. No matter how knowledgeable and
competent we become, we can’t cure kids or fix other people’s lives.
Nor can medical practitioners, by the way, but at least they have the
backing of the pharmaceutical industry to help create and maintain the
illusion. Whatever illusions of “success” we might create, however,
we will always be hiding behind a pretense – making the usual excuses
(not enough money, resources, support, etc.) while running away from the
realities of our own failures. If you question this, take a look at the
history of psychotherapy – a branch of professional “helping” that
was once embraced by the medical fraternity but subsequently dumped in
favour of drug therapy. This left “clinical” psychologists,
“clinical” social workers and a bunch of also-rans holding the
abandoned baby with child and youth care workers standing by to play the
role of nursemaid. Sorry folks, but there's nowhere to go from here
unless, of course, you enjoy spending your summer evenings at garden
parties listening to those who still manage to make the model work –
with a little bit of help from their friends.
So, what's to be done? Can we really break away from the grips of the
monster that spawned so many of us? Of course we can. Are there
alternative ways of working with kids and families? You bet there are.
But, for me, this means delving into the soul of our profession, into
the stuff of our own lives and the lives of those we call “clients.”
It means throwing away the illusions of power, dropping the pretenses
and approaching each life as a unique and fascinating part of the human
experience. But this is not the place for such speculation. Hopefully,
Thom Garfat will allow me to go on about this in his upcoming issue on
Self and Relationships. If not, there’s always the chance that Doctor
Garfat is one of them.
___