Careless to caring for troubled youth:
In the past, Americans assumed that troubled youth were well taken care of once the proper service or placement was identified. The general feeling was that people who ran programs for youth knew what they were doing. Fortunately, recent investigations and the current push to deinstitutionalize services have alerted people to the inherent dangers in this kind of simplistic thinking. In scrutinizing programs, however, the media and investigators have tended to accentuate the extremes rather than concentrate on the daily dilemmas and problems encountered by caregivers and youth. While the public needs to know about extreme cases of neglect and abuse, this information presented alone, as it often is, does little to improve the caregiving system. All it really has done is shift the public attitude from being very naive to being extremely skeptical about the youth care system.
I have developed four examples for this chapter in an attempt to paint a realistic picture of what happens to many youth in need of special programs. As the reader shall soon learn, these programs can’t be characterized as all bad or all good. Instead, a more accurate description might be that these programs are places where youth are often caught between caregivers’ honest intentions to deliver the best possible care and their frustrations over not receiving the training, supervision, and support they need to deliver it.
The first example shows what often happens to a youth in a program where caregivers are unable to maintain a long term commitment to their work. In this particular program, like so many, sufficient resources were put into materials, supplies and programs, but not into salaries and career incentives for caregivers.
John, a troubled ten year old. had been giving his third grade teacher a difficult time for several months before she finally went to the principal and asked to have him removed from her class. John fought with his classmates. used obscene language. started two fires in the wastebasket and never did his class assignments or homework. The teacher was aware of John’s long history of troubles and his miserable home life. but things had reached the point where she felt completely helpless. Besides, it just did net seem fair for her to have to spend so much time with John at the expense of the others.
Under these circumstances the principal felt justified in requesting another diagnostic evaluation to determine whether or not an alternative placement might be more appropriate. After the evaluation and much deliberation among school officials. county social workers and John’s parents, a consensus was reached to refer John to Hilldale, a local residential treatment center for emotionally disturbed youth. Hilldale had just made some major revisions in its treatment philosophy and its physical facilities. As a result of these revisions, Hilldale’s staff were able to boast that they were capable of helping some very difficult youth in a relatively short period of time (18 months to two years). Homelike living quarters intensive individual and family therapy, a special education staff and dedicated child care workers, were some of the enticements offered to the referring agency and John’s parents.
As part of the referral process, Hilldale sent a team of workers to observe John at school and at home. During these visits John got to meet Jack, a social worker, Melissa, a special education teacher, and Rick, a child care worker. Together these people formed one of Hilldale’s treatment teams. Their purpose in observing was to determine whether or not John would be appropriately placed at Hilldale and, if so, in which treatment group. This was also viewed as an opportunity for John and his parents to become familiar with some of the Hilldale staff members.
The referral process led to an agreement among all those involved that Hilldale was indeed the best possible placement for John.
When John arrived at Hilldale. Jack, Rick. and two additional child care workers. Kathy and Jeff. were there to greet him. The Hilldale staff had decided that John would fit in best with a group of six youths being treated by the staff members who had done the intake study. And as was the Hilldale policy, these staff members were responsible for making John’s arrival as pleasant as possible. So, together with John’s mother (his father had gotten drunk and couldn’t make it), the staff helped John unpack and get accustomed to his new room.
Once the unpacking was done. John’s mother went down to Jack’s office for a visit and John and the three child care workers sat down for some cookies and milk. It was at this point that John, learned about some of Hilldale’s basic rules, got an idea of what a routine day was like at the center, heard about the recreational activities the group participated in, and got to know more about Kathy and Jeff, the two child care workers who were not involved in the referral study. After about an hour of discussion John also got to meet his roommate, Tony, and the rest of the group.
It didn’t take John long to realize that the child care workers, Kathy, Rick and Jeff were the people he would be spending most of his time with. One of them was always there: in the morning, after school, at night, on the weekends and during the day when he couldn’t hack it at Hilldale’s school. Under these circumstances it was only natural for him to begin to feel if he was going to risk being friendly with an adult. It would probably have to be one of these three.
Rick was 24 and had been at Hilldale for about a year. He had a degree in business administration, but after becoming frustrated with the business world, decided to try his hand at working with kids. Kathy was 22. She had just started at Hilldale. Her degree in Art, combined with a great deal of enthusiasm for working with youth, seemed to make her an excellent candidate for child care work.
Jeff, at 34, was considered the old pro. He had gone into the Army after high school and, after a six year hitch, decided to get into child care work. Hilldale was the fourth center he had been employed at in the last ten years, but his supervisor was convinced that Jeff had finally found a home. At least, nothing in his first two years at Hilldale indicated otherwise.
At the first six month progress report meeting, Rick, Kathy and Jeff reported that things were going about as well as could be expected with John. There, of course, had been all of the usual phases that take place during a child’s adjustment period: a honeymoon phase in which things seem too good to be true followed by a testing phase in which the staff saw John’s behavior extremes and, finally, a settling in phase in which John began to behave about as had been predicted by his third grade teacher and his parents.
Several positives were also noted. John had excellent athletic skills and he seemed to be getting along quite well with Harry, a boy in the group with similar interests and abilities. But, perhaps most important, John was beginning to develop a good relationship with Kathy. Jeff and Rick reported that he looked forward to her shifts on duty and according to Kathy, John was beginning to talk with her before bedtime about his problems. This was extremely significant, considering that John’s previous interactions with his parents and other adults had been characterized as very distant and non-communicative.
Jack, the social worker, reported that family and individual therapy were still in the early phases of getting to know each other. Jack seemed quite surprised when he heard that John was getting close to Kathy.
In school, Melissa, the special education teacher, was totally frustrated. She was grateful that the child care workers were helping out by taking John for a portion of the school day and involving him in arts and crafts projects. But even during the limited time that he was in the classroom, his short attention span and his high anxiety level made it very difficult for him to get any work done. Melissa felt that as she got to know John better, and as he began to experience more success on the living unit. things would also pick up in the classroom.
So after six months, John’s prognosis was guarded, but tempered with some optimism due to his relationship with Kathy and Harry and the success he was having in athletics. One evening, about eight months into John’s treatment at Hilldale, a special group meeting was called by Kathy. This worried John as it did the rest of the group members because special meetings usually meant there was either a major discipline problem or one of the staff members was about to leave Hilldale. In this case the latter proved to be true. Kathy was leaving Hilldale to pursue an opportunity that would “help her grow as a person.” Actually the job had become too demanding. The long hours and constant verbal and physical abuse that ‘were part of child care work had squelched the initial energy and enthusiasm Kathy had brought to the job. Besides she had found a part-time job that paid almost as much as her full-time child care job and this would give her an opportunity to return to school and get the additional training she needed to become a school teacher.
Even though Kathy made a point of assuring John that he had nothing to do with her leaving. John couldn’t help but feel that it as his fault. As far as he was concerned, this was just another case of an adult abandoning him because he was too difficult to get along with. He was more convinced than ever that he was no good and that it really wasn’t worthwhile to try to get close to – and trust adults.
During the next month John was caught trying to set a fire. He also got into several fights and created several major disturbances in school. Then, as if Kathy’s leaving wasn’t enough, a similar announcement was made by Jeff. He had accepted a job as a bus driver. The increase in pay was something he really needed for his family.
Jeff’s announcement came as a complete surprise to the administrative staff. but not to Jeff’s fellow child care workers and many of the youth. He had told them that he had put his name in at the bus company several months prior to his announcement, and he had been expressing anger towards administrative and clinical staff members. Jeff didn’t feel his input at meetings was really valued and he was certain that other staff members were jealous of his ability to handle the kids.
Although John had not been as close to Jeff as he was to Kathy, he nonetheless felt very insecure about Jeff’s leaving. Jeff was very dependable and he was viewed as the one person who could usually restore order when the group got out of control. Jeff was also coach of the football team. After he left, John stopped going to football practice.
At the first year’s progress report meeting all the staff felt that John’s condition had deteriorated over the last six months. This was understandable considering both Kathy and Jeff had left. Rick reported that he was trying to get a better relationship going with John, but he was finding it very difficult because he was so busy helping the new child care workers.
Two months later Rick announced he was leaving. He was “burnt-out”. Trying to break in two new child care workers was just too much for him. He was also bitter about the fact that he didn’t receive any additional Incentive or recognition for all the extra hours he put in when Jeff and Kathy left.
Rick’s colleagues were also aware that he was troubled by the fact that his friends didn’t think very highly of the kind of work he was doing. They would say “we admire you for having the patience it takes for working with these kids”, but privately they were questioning what he, was doing with a job that had little if any future.
At the eighteen month progress report meeting, Phil, Barb and Dave, the new child care workers, reported that some small gains were being made with John. There were, of course, the usual phases that take place when a child attempts to adjust to new staff members: a honeymoon period ...
Emotionally disturbed youth in residential centers often
find themselves in situations which are already too familiar. Many of them have
been physically and emotion ally abandoned many times prior to entering
residential treatment. Needless to say, continual separation from one child care
worker after another does little to restore their confidence in themselves and
adults in general. And these youths are often placed in residential facilities
as a last resort the hope being that the intensity of the live-in situation will
create an opportunity for meaningful adult-youth relationships. ”