CONTENTS

This article is about the nature of care itself, about what draws us to it and what guides us in care- giving. According to Ricks (1992) the ‘concept of caring … is the foundation for our field of practice.’ It is a concept, however, that since Ricks’ article has remained largely undeveloped. The basic premise of my argument here is that caring is ultimately a moral endeavour rather than a primarily practical one. This requires that, at a conceptual level we begin to consider residential child care through a lens of moral philosophy as well as those of psychology and sociology, which have come to frame our field.

Child and Youth Care work is simple and complex in the same moment. The ability to create simple responses based on complex understanding is the heart of effective practice.

Picture a little boy’s face red with hate, eyes swollen with sadness, body so tight with anger. Sadly, I wonder if this is too easy for some of us to imagine. I know for me it isn’t difficult because this boy is a child I worked with a year ago, but who still enters my thoughts regularly.

Have you ever felt powerless and disabled from making decisions? Has the fear of change or transition ever left you pretending that the events you are experiencing are not happening to you? Most people experience moments like this in life, sometimes as a result of bereavement or loss, sometimes out of a crisis beyond their control. These are not the everyday experience of most of us; they are points of crisis in time. They are not a regular occurrence in our lives, and consequently most of us recover. Can you imagine, however, sustained and consistent periods change and transition in your life with the feelings noted above, and if you can, can you imagine yourself being able to function with any degree of normality? Welcome to the world of the troubled youth in care environments throughout the world.

This particular column is being written in Montreal following the first day of Beyond Borders: Caring for the Future of Children, Youth and Families; Au-delà des frontièrs: notre attachement aux enfants et aux familles, the 8th International Child and Youth Care Conference and concurrently, the 14th National Child and Youth Care Conference.

The behaviour management of children in residential care remains one of the most talked about challenges, not only among child and youth care workers, but also among other mental health practitioners in the residential care setting. Whenever training needs among residential care staff are analyzed, behaviour management seems to always find its way to the top of the list. Even among supervisory and managerial staff, the management of challenging behaviour of children occupies much of the time used for general discussions, supervision and case studies.

Nowadays, it’s rare to come across any definition of Child and Youth Care that doesn’t include the word “relationship”. Since the same thing cannot be said about psychiatry, psychology, social work or teaching, it might be assumed that this is actually the connecting element, or quality, of this otherwise diverse profession. But if you look closely at how this term is used, you will probably see that most Child and Youth Care practitioners view their relationships with their young “clients” as vehicles for change, crucibles for the alchemy of many ambitions. This is usually expressed as the “use of the relationship,” in much the same way as we talk about the “use of the Self.” Personally, I find both these statements to be equally repulsive. Let me explain.

How we deal with youth who are leaving residential care has a powerful effect on post-placement adjustment. This article reviews relevant literature from a range of helping professions and outlines implications for managing termination with children and youth in care. 　

EDITORIAL

Group care and treatment

Group care and treatment are the history of our field. It is in this context that we learned, developed and came to be as a profession. It is in this context where we learned about the anger and pain of young people; where we learned about the importance of environment; where we learned about the importance of the everyday moments and opportunities. It was in this context that we developed a child and youth care approach, unique ways of being in relationship and how to be with other without sacrificing self. It has been a powerful learning laboratory. It is our history and should be a part of who we are and how we define ourselves.

In many ways we have outgrown it. And in many ways we are only just now growing into it. That, of course, is a part of the current dilemma facing our field. As we move forward into new areas of practice, beyond the walls of the residential facilities, how to we take our history forward so we do not lose that which we have learned.

People much wiser than myself have explained how there will always be a need for residential care and treatment, how there will always be some youth and families who need, and can only really benefit from, residential care or treatment. Nothing else will be enough. Nothing else will be able to provide the service they need: a total, planned, environmental context for growth and development.

On the other hand there are many other wise people who see group care as an unfortunate evil and advocate that no youth should ever be so placed. They see group care as an intrusive and out-dated way of helping that only exists because governments and funding bodies are not prepared to move forward to a different, better service. Are these, necessarily opposing views, as they appear to be at first glance?

I make no secret of it: professionally, I ‘grew up’ in group care. It was my first experience of helping young people and I confess to having a love for it still today. There is no place I find as exciting, as full of learning opportunities, or as comfortable for me. Well, I guess ‘home’ is like that ideally. And, I have argued elsewhere, that everyone should work in group care before moving on to more ‘independent’ forms of practice because, truth is, I worry for those who helping without the solid foundation that comes from such an experience.

I am also aware that the experience many staff have in residential group care is not a good foundation for moving forward to other areas of practice because not all programs are programs of positive learning and development.

And I worry about what I see happening around the country. As society becomes more frustrated with the actions of young people, there is a rising cry for greater control and authority to be exercised over young people who ‘get into trouble.’ I can understand this – some people are frightened, and some people are concerned. As the media exploits the troubles of young people and the fear of the general population, through ever increasing dramatic coverage of their actions, we become understandably more concerned and frightened.

But that does not justify a return to the old days of institutional care. It does not justify re-creating environments of control, authority and the objectification of young people: demonizing them like animals to be caged and contained. Okay, I am getting carried away here, but this is an editorial and I am allowed to do so.

Our concern and fear, I would argue, should be used to drive us forward, not backward. Just as many programs are discovering new ways to refine group care so that it can make a greater difference, group care is threatened with a reversal: a halt in its development. More isolation rooms, more restraints, more controlling staff.

Why would we want to go back? We moved forward partially because of the tremendous abuse that occurred in such environments. When staff were encourage to control, exercise power and, essentially, overpower – we saw a multitude of abuses to which we all reacted with appropriate shock and horror. Why would we want to go back there?

As we have learned to respond to young people’s needs, rather than just their behaviours, we have seen tremendous progress. We have seen a more appropriate (yes, I know it is far from perfect) balance between the necessary containment and the teaching of new ways for young people and families to have their needs met.

As Grant Charles says in this issue, we may be on the edge of developing specialized group care programs which address the specific needs of specific young people. As Mark Smith advocates, we need to approach these young people with an appropriate love of spirit which will help us to ‘reach the unreachable.’ As Jack Phelan says, young people and their families “have complex behaviors that emerge from complex sources.” Simple solutions of the past are simply not going to work today, just as they did not work in the past. It is a time to move forward, not a time to move back. The old solutions, I repeat, are not going to work now, just as they did not work then.

Don’t get me wrong. I am not for a second advocating that we should all stand up and cheer the current state of residential group care, and advocate for its continuance. I am not blind to the inappropriate, controlling, demeaning environments that I have experienced. And I am not foolish enough to believe that untrained staff, hired to simply control young people, is a good answer.

I am of the belief that group care will be here forever, that it will be needed forever, and that it is our responsibility not to advocate for its demise, but rather to advocate for the right program for the right child at the right time. I know it is politically correct to advocate for the abolition of group care but as anyone who has worked in alternative programs for youth and their families knows, sometimes it is not only the only answer, but sometimes it is the right answer as well. But not just ‘any old program’ – the right program is what is needed.

My position is that if we really care about services to troubled young people and their families, we would stop advocating for the abolition of group care for young people and their families. Rather, we would be arguing for the refinement of those services, so that those young people and families who really need it can get what they deserve – refined and appropriately defined services.

After all, if the young people who can be helped through outreach programs are entitled to those services, are not the young people who need group care also so entitled?

Maybe it is time to get off the ‘politically correct’ horse, and get on the ‘appropriate service’ one. It is a time to move forward.

And thus this issue, in which you will find some ideas about how to make it better for those who need it. We are not suggesting that the answer to the future lies in these pages, but maybe you will find a stimulus here.

Thom Garfat
Isle de Belair

BACK

______________