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ISSN 0840-982X

VOLUME 18 NUMBER 2

• Table of contents
• Editorial

Practice hint: Value-added tax 60

Archive: Attachment development is “in” 61
Henry W. Maier

Food for thought 72
Kim King

Why I do 74
Garth Goodwin

Books: Heroin in a small town 76
Donna Jamieson

Relationships can take us to legislation as an option
for professional regulation 77
Carol Stuart

Men: Reflection in action 79
Thom Garfat

On hitting, hand-cuffing, caring 81
Karl Gompf

Last words: Discharge diagnosis 82
 

On the Risks of Outreach

It seems that everyone is wanting to ‘do outreach’ these days – meeting the families of youth in care in their homes; meeting with youth to try and prevent placement; meeting with families who just need help re-organising their lives in to a less painful and troublesome configuration of being together, helping youth to find more meaningful ways to be in the community, helping young people find their place in school systems, etc., etc.. And this is as it should be, I think. For too long young people have been placed in care just because we, as a society, did not want to allocate the resources necessary to help them in their environment – or because we didn’t believe in it, or because we were afraid – whatever the reasons, we didn’t used to do as much outreach as we do now. It even seems, as Lesibo Molepo (2005) says, that “organizations seem to feel almost obliged to venture into this area of work” and may suffer funding penalties if they don’t do so. And, as Bocarro (2002) says “there is a growing movement to move youth workers into communities where they can work directly with youth, rather than waiting for youth to take the initiative to go to a fixed program site”. We now see outreach programs engaging Child and Youth Care workers to work with families, work on the streets, in recreation programs, in schools, from hospitals, in health promotion programs, and much more. So be it. That is the way it is.

But, I must confess, I am concerned. It seems that everyone is jumping in to this area, but that not everyone is taking the time to ensure that we are doing it well. Lately I have been having discussion with CYC people involved in outreach and it appears that there are a few areas to witch we really need to address ourselves. Specifically, these include:

• A lack of adequate training and preparation for staff

• A lack of a clear mandate for programs.

• A lack of appropriate supervision

• A lack of attention to the ‘details of safety’ for staff

And it is to these four areas that I wish to address the rest of this little editorial.
Adequate training and preparation for staff

Let’s start by acknowledging that, as writers like Jack Phelan (2003), Mark Hill (2003), Kelly Shaw (2003), and yes, even myself (Garfat 2003, 2004) have said, group care work is a fine learning environment and a great place to learn many of the skills one will need in doing outreach work with youth and families. But let’s also acknowledge that such experience is not, and can never be, enough. There is much more involved in outreach work than the straightforward extension of current staff abilities in to the community.

One cannot simply leap from the confines of group care, for example, into outreach work. And one cannot simply be hired in to outreach work and be expected to do well without adequate preparation and training. Such preparation and training might include, just as an example, things like:

• The translation of the characteristics of a CYC approach in to the community and/or family context

• Understanding behaviour in the community or family context

• Family and community focussed interventions

• Thinking systemically

• Working independently

• Re-aligning one’s alliances

• Exploring self-reactions to family or the social conditions which surround youth

Well, there is much more, of course, but the point is that in order for a Child and Youth Care worker to move into outreach work, and especially family outreach work, considerable preparation is required. There is, in fact, a ‘process of development’ which staff could follow to help them be prepared – it is unfair to staff, youth, and families to simply send the staff out there, untrained, uneducated and unprepared. And, quite frankly, it is both unethical and unprofessional.

 Unfortunately, most CYC’s enter in to the work, unprepared – and that does not speak ill of them. It is rather, a criticism of the systems for witch they work.

Clarity of mandate
Outreach work is not the intervention of choice for all people or families, all of the time. Yet as governments and organisations see the benefits (both therapeutically and financially) of outreach work, there seems to be a push to ‘do outreach’ with everyone; as if somehow we have found a new cure for the many difficulties that plague families and young people in our communities. But surely there have to be limits to this new ‘wonder-approach’? Just like – we finally discovered – there are limits to the benefits of group care. Maybe we could learn from our past errors and avoid repeating the ‘one approach for everyone’ heresy which came close to destroying residential and group care not that long ago. I fear that family work and outreach are becoming the new ‘panacea’ of our times.

Just as a group care program needs a clear mandate (I mean, we do all agree, don’t we, that you don’t normally mix certain groups together, or that there are certain youth who cannot benefit from group care placement?) so an outreach program needs a specific mandate in order to focus the resources, and the possibilities of success for young people, staff and families of the program.

A program needs to be clear about who they can help, and who they can’t. And a program needs to be clear about what services they can offer, and which ones they can not. After all, no-one I have met so far has been able to do everything all the time. And no program, no matter how good it is, can be all things to all people.

When we fail to have a clear mandate we put the staff, the youth, and the families, at risk.

Adequate supervision
Please notice here that I am only asking for ‘adequate supervision’. As Fulcher (2003) has said, maybe if we just had ‘good enough’ care (Winnicott, 1960), that would be better than what we have now – and certainly, in our field, the history of ‘good enough’ supervision is missing. The typical Child and Youth Care worker in a group care program has seldom received adequate supervision (at least in North America) so why should we expect it would be any different just because we are engaged in outreach work. The average supervisor has had no experience of adequate supervision and certainly no training in how to be a supervisor. So, somehow, just because we engage in outreach, the supervisor is miraculously transformed in to an adequate supervisor – I don’t think so!

And yet in too many programs we are sending Child and Youth Care workers out in to the field to do intensive outreach with sadly troubled young people and/or families – and this without the benefit of adequate supervision. Without supervision to help the Child and Youth Care worker understand the ‘case’, without supervision to help the Child and Youth Care process the issues which arise, or to help the Child and Youth Care worker make the transition or adaptation or to help the Child and Youth Care worker make wise decisions about what services to offer and what to do.

Why do we keep doing this? Have we not learned from our previous mistakes? Do we want to undermine the professional credibility of our field? Let’s be honest here – just as group care supervisors have certain things that they need to know or know how to do (Maier, 1985) so, too, do outreach supervisors. Just as the staff cannot simply ‘make the leap’ neither can the supervisor. There are different skills and knowledge required ... like, for example, what ‘model’ of supervision to use. Do we use a model ‘borrowed’ from other fields, or do we use a Child and Youth Care approach to supervision (Garfat, 2001)? Do we, as supervisors, understand the issues involved in outreach work? Are we able to help the Child and Youth Care worker re-create the moment in supervision so that we can enter in to the experience, on whatever level, with her?

Details of safety
A friend of mine works in an outreach program in a large North American community. Some of her visits take her to parts of town that we might not, as conservative people, choose to visit on other days. Yet the agency she works for chooses not to provide her with a cell phone. So, what if she gets in to a risky situation? What if her car breaks down late in the evening? What if she needs help? But these are the most obvious risks and solutions. Here are a few other things we might want to think about. Outreach workers:

• Should have an immediate way to contact support (and help) when necessary

• Should always have someone who knows where they are going and when they are expected back

• Should know where community support resources are located

• Should, if they drive around, have an emergency roadside service available to them.

• Should work in teams whenever there is an assessed risk to the worker.

One of the things that we talk abut when discussing the Child and Youth Care relationship is the necessity of creating a ‘relationship of safety’. How, I wonder, is such a thing possible when we put our workers ‘at risk’ through our own failure to attend to the some basic issues which might help outreach workers ‘feel’ safer? How can we, as organisations which supposedly care for people, put our staff at risk like this? Does it not make sense, from a simple safety point of view, to ensure that our workers ‘feel’ safe?

So what are the risks?
Outreach workers are leading the development of the field in a very important and exciting (and wanted, it would seem) area. In the most fundamental of ways, they are meeting clients, as Mark Krueger (1991) says, ‘where they are at’, in their communities and homes. They are moving the best of Child and Youth Care practice from the institution to the community. They are actualizing one of the defining characteristics of a Child and Youth Care approach, ‘being with people, as they live their lives, where they live their lives’ (See, for example, Garfat & McElwee, 2001). When we fail to ensure that they are provided with adequate training, an appropriate mandate, adequate supervision and minimal safety, we put both workers and the families and youth at risk. And what are the risks? Well, here are a few:

• The threat to physical safety of the worker

• The risk of inappropriate interventions

• A threat to professional integrity

• A threat to individual worker’s feelings of value and competence

• Limitations to the level of interpersonal risk the worker is willing to experience

Surely we owe it to youth, families and staff to do better than this?

Thom
Rosemere, Quebec


Bibliography
Bocarro, J. (2002). Moving Beyond the Walls: The Need for Youth Outreach Programs. Parks & Recreation. Issue: March 2002
Fulcher, L. (2003) Personal communication, referencing D. Winnicott (1960).
Garfat, T. (Ed.) (2003) A child and youth care approach to working with families. New York: Haworth Press.
Garfat, T. (2001). Congruence between supervision and practice. Journal of Child and Youth Care. 15(2), iii-iv.
Garfat, T. & McElwee, N. (2001). The changing role of family in child and youth care practice. Journal of Child and Youth Care Work. 15. 236-248.
Hill, M. (2003). Supervision and outreach. In T. Garfat, (Ed.) 2003. A child and youth care approach to working with families. New York: Haworth Press.
Krueger, M.A. (1991). Coming from your center, being there, meeting them where they’re at, interacting together, counselling on the go, creating circles of caring, discovering and using self, and caring for one another: Central themes in professional child and youth care. Journal of Child and Youth Care, 5(1), 77—87.
Maier, H. W. (1985). Teaching and training as a facet of supervision of child care staff: An overview. Journal of Child Care, 2(4), 49-52.
Malepo, L. (2005, in press). Community child and youth care work. Relational Child and Youth Care Practice. 18(2)
Phelan, J. 2003. Child and youth care family support. In Garfat, T. (Ed.) 2003. A child and youth care approach to working with families. New York: Haworth Press.
Shaw, K.. & Garfat, T. (2003). From front line to family home: A youth care approach to working with families. In T. Garfat, (Ed.) 2003. A child and youth care approach to working with families. New York: Haworth Press.
Winnicott, D. W. (1960) The maturational processes and the facilitating environment. London: Hogarth Press