SPECIAL SERIES: CHAPTER*
Developing a shared language and practice
Stephen F. Casson
More than a job — a pound of flesh
It is 3.45 p.m. Jerry, a group home worker, is responsible for twelve adolescent boys and girls, ranging in age from fifteen to eighteen, who are returning from work or school. His colleague who should have been on duty has just called in sick. This colleague predicts she will be away from her work for seven days. Two residents are preparing a sandwich, another is watching television, one is getting ready to go out and two of the others are doing nothing in particular. Jerry knows he has to take care of all that happens until two other group home workers arrive at 8 a.m. the next day. He calculates that there are 164 hours left as the minutes start ticking by interminably slowly. Jerry keeps his fingers crossed that tonight the residents will behave themselves, perhaps watch television, go out to a disco or just do anything that interests them. If all goes well, he will write up some case records, bring some financial accounts up to date, and generally be helpful. He will make his mark on this shift, so at the staff meeting people will recognize the hard work he has put in to get the paperwork up to date. He might even have time to watch the film on television at 8 p.m. If there are only three or four residents in the building, it might be a pleasantly quiet evening.
Commentary: What is the purpose of Jerry coming to work? What should he do with the residents until they go to bed? How should Jerry or any group home worker spend his time with a group of adolescents? To what extent does he organize activities for them, arrange transport, and go places? What would be the point of it? Should he go and rent a couple of video films to entertain a sizeable number of boys and girls and thereby probably encourage them to stay in? Should he have a heart-to-heart conversation with the two residents with whom he gets on best, to help them straighten out some of their problems (is this counselling?)? On the other hand, should he do nothing at all, as this would be a good preparation for the residents to learn how to fill up their own time, to work out for themselves how to spend the evening and be a bit realistic about life in the big wide world?
A social worker for Julie, aged seventeen and four months pregnant, drops in to talk about Julie and her plans for the future. She wants to talk to Jerry privately in the office. Jerry wishes she had more sensitivity about how the establishment works and realized he should be amongst the boys and girls as they return home from school. Perhaps she might telephone next time to make an appointment? What is the point of talking to her anyway — she is not interested and he has got too much to do. At least she might spend an hour with Julie which will keep her quiet.
The phone rings and it is an assertive auditor saying he is coming tomorrow morning to go through the books. The group home worker explains that tomorrow there is a staff meeting. The auditor states that he only needs an hour from the senior worker in the establishment and that will not cause too much disruption to the staff meeting. He will arrive at 10.30 a.m. Jerry feels a surge of anger that this outsider — probably in a suit — takes no notice of him and intends to interfere with an important meeting. There will be less time to discuss four residents due for in-depth discussion. Oh well, the interminable conversations about residents get nowhere, so an hour less might be a good thing.
Commentary: Where does Jerry stand with an unscheduled visit from a social worker and insensitive high pressure from an auditor? Should he tell them both to come at a time convenient to the establishment, or should the establishment constantly shuffle its operations like a small pack of cards to maintain the good will and co-operation of outsiders? Whatever Jerry decides, how will he know whether or not he is doing the ‘right thing’? If he means to ensure outsiders come at convenient times, how will he go about influencing the social worker and auditor to co-operate? If what he does succeeds will he be looked upon as a competent and mature person and if there are complaints, what will if be that he has done wrong?
Charles, an aggressive sixteen-year-old who recently left school, throws himself into the office complaining that he will not work an hour longer at the Youth Employment Programme where he has been working. Someone has accused Charles of stealing money. He tells Jerry what he can do with the job, and that what is more, he will not be looking for another one. The group home worker feels embarrassed to be the subject of such an outburst in front of the social worker. He wonders what she is thinking about him, allowing this verbal aggression and all these interruptions, when he is meant to be talking with her. Jerry thinks, ‘If only I had more time and there was someone else working with me, then things would be different.’
Jerry nods to the social worker to let her know that he has not forgotten his business with her, while he reassures Charles that he realizes he must have a lot of strong feelings about what has just happened at work. ‘However, I will spend time with you later’, says Jerry, ‘because I am talking to the social worker about an important matter just now.’ Charles shouts at Jerry that if that is the way he feels about his being called a liar and a thief then it isn’t important to Jerry; he will go out and break into somebody’s home and it will all be Jerry’s fault. In his own head, Jerry believes he should be talking with Charles, yet why does he receive the blame? He is only doing his job.
Commentary: What is the optimum approach to working with Charles? What kind of person is he? Can he be described or assessed in such a way that Jerry is given an immediate knowledge of how to deal with this anger and hurt? Should Jerry immediately stop what he is doing with the social worker and turn all his sympathy to Charles? Should he model to Charles the social skill of holding an emotion in check until the ‘right time’ to let it out? Should he be very matter-of- fact in his approach to Charles? Should he let him know that it is Charles’s problem and although he might help Charles work out what to do, the solution rests with Charles? Should he immediately act on Charles’s behalf, call the Youth Employment Programme, sort things out, and try to get him another chance? How can a group home worker know what response to give Charles apart from an intuitive guess about what might work, or on the other hand what might not? If his response does not help, then his competence is undermined in his own eyes and those of his colleagues.
At that moment the doorbell rings and in walks a man delivering numerous food provisions for the next seven days. He comes into the office to get a signature and to explain why the provisions delivered are different from what was ordered; how certain missing items will be delivered next week; and how this will not affect the bill, as ... Jerry signs the order form and makes a few notes at the bottom about next week’s order. Charles and the delivery man leave the office.
The social worker talks about Julie’s pregnancy with Jerry as he finishes his note about the provisions. She wants to know what Julie thinks about adoption. Jerry, who has not seen Julie for some time and has never talked to her about adoption, shows his impatience. He has suddenly remembered that the agency’s local maintenance crew have not yet unblocked the drains from the first-floor kitchen and toilet, although someone telephoned them five hours ago with an urgent request. Jerry apologizes to the social worker and excuses himself, suggesting she return when Julie’s key or primary worker is on duty and, together, she and the social worker can plan the next stage. He inwardly curses the time and energy he has expended on this irritating woman.
Jerry telephones the maintenance service and finds that there is no chance that they will arrive before tomorrow afternoon. He telephones the supervisor but gets no reply. He looks through the Yellow Pages for emergency drain cleaning numbers and makes arrangements for one company to visit within the next two hours. Just as he is congratulating himself on solving the problem, he hears shouting in the passage. He looks out and finds Mark being accosted by a middle-aged man and a younger woman. He has never seen them before. Jerry tries to put his stamp of authority on the scene. ‘What is going on?’ he demands. The older man, smelling of alcohol, says he is Mark’s father and this is his new wife. He is not leaving without Mark, as he is having to pay a sizeable proportion of his wages to keep his son in this den of iniquity. ‘Look at those two,’ he says, as he points at two girls reclining on a settee, one with a dress slid halfway up her thighs and the other with her mouth open and her tongue provocatively aggravating Mark’s father. This older man walks up to Jerry, and standing only three feet away from his face, demands that Jerry should tell Mark to pack and that he should hand over all Mark’s money, medical card, and so on.
The group home worker’s blood is thumping through his body. His mouth is dry. Jerry tells Mark, his father, and the new wife that he is not going to carry on an argument like this in front of everybody. If they want to discuss it then they can come into the office. In the office Mark’s father stands over Jerry as he sits in a chair, and shouts belligerently. Mark tells his father to stop it. Jerry informs all three parties that if Mark leaves the building, the police will be called and he will be reported as an absconder. Mark solves the problem by telling his father that he will not go with him. He has never given him any breaks in life and therefore he does not want anything to do with him now. He storms out of the group home. The father blames Jerry and threatens him. Twenty minutes later the father and his new wife leave, telling Jerry that they will be back to get their revenge.
Commentary: What is the optimum approach this worker could use to reduce the turmoil with Mark, his father, and new wife? Should he be confronting, reflective, directive, or permissive? Is it a matter of chance whether the intervention of this worker causes a belligerent response or reduced tension? Do different workers deal with this sort of situation in a purely idiosyncratic way that reflects their personality? If one approach works, should all workers adopt that approach whether or not the recipe will be as effective for other colleagues? Is it possible to weigh up the characteristics of the children, the characteristics of the group home worker, and the characteristics of the setting to come up with a recipe that will work for everyone in this situation at that time with those particular people? If this does not work, is the solution that one recruits workers solely on the basis that in their own indomitable way, the right personalities can deal with all comers? Does a person who can deal with all comers and all situations do anything other than enforce a spirit of calm, order, and control on an establishment whether or not this has anything to do with development and growth for children? Will one energetic worker operate in a unique and different way from other persevering staff?
Jerry goes into the main living area to welcome back three residents who have been working. He is about to ask them how their day has gone when the emergency drain cleaners arrive. Jerry shows them what is blocked and leaves them to it. A couple of girls, immaturely and with much noise, follow the workmen around making loud whispers about their looks and how they are not likely to be worthy of their attention because of their menial job as drain cleaners. The two men respond in kind and Jerry attempts to move the girls elsewhere. They are abusive to him, they resist and enjoy being the centre of attention. Jerry gives up, returning to the kitchen, feeling embarrassed that he has so little power and influence on residents that he knows well when they are willing to publicly abuse him. He finds a couple of boys unearthing fruit and biscuits from the boxes of supplies. He reacts angrily as he has not yet checked the produce that has been left. He starts the inventory of those provisions to ensure everything is there. He makes a note that they are 4 lb of butter short. He asks a resident to put the supplies away for him.
It is now 6.30 p.m. The boy and girl responsible for preparing and cooking the evening meal for everybody have not returned from school. Jerry asks Fiona and Marian if they will do it. They refuse. Jerry debates in his mind whether to force the issue and tell them they have got to do it. Instead, he asks another resident, John, who says he might but only if Jerry gives him three cigarettes. They end up in an argument about people only doing things if they are paid for them. Jerry becomes more irate with this non co-operation and starts peeling potatoes and preparing vegetables himself.
Commentary: Are there some common attributes or
strategies which can make an impact on provocative adolescent girls or
residents that refuse to help out with the overall functioning of the
establishment? If people will not give a hand, is it best to let people
go hungry or should the group home worker do it himself ? After all, the
worker is responsible for the nutritional needs of the adolescents. Is
bribery or cajoling people with future reinforcement relevant here? Is
it preferable to let the attention-seeking girls work it out with the
drain-cleaning crew or is
intervening strongly more appropriate? How does a group home worker come up with an answer?
The two drain cleaners tell Jerry they have finished, get him to sign that the work is complete, and they leave. Jerry checks the toilets and showers and finds them working adequately. At that moment the drain cleaners return and state that a wallet has been taken from a jacket in the van outside. The crime must have been engineered by a resident from the home. Two of the residents immediately start arguing with the cleaners that in no way are they thieves and how dare they blame poor unfortunates who live in residential care. The men shout back and insults are thrown to and fro. Jerry tells the cleaners he has no evidence about who took the wallet and they ought therefore to call the police. The telephone call is made. Forty minutes later two policemen arrive and interview the two men, Jerry, and all the group home residents who were around at the time. Jerry has to sit in on each interview with the residents. The police, no further on, leave at 8.50 p.m. No evening meal has been cooked. The two residents who should have prepared dinner have still not returned. Jerry questions in his mind when to report them as missing.
By this time eight people are hungry and are waiting for a meal. They criticize Jerry for not being a proper child care worker since he has not provided adequate food and nutrition. Jerry calls them all into the lounge. He states he is not prepared to do the work, and unless he has some volunteers who will make the meal, everyone will go hungry. Jerry questions in his own mind whether he is doing the right thing or not, and whether it is his duty to get adequate food prepared for each person.
Three residents volunteer to do the cooking. Jerry sits down to discuss with the two girls the provoking of the drain cleaners. He asks them what they were trying to achieve. They laugh. He tells them in strong, cutting terms that their behaviour is unacceptable and that they have given the home a bad name. This could mean that in retaliation service companies may provide only a second-rate service in the future.
Commentary: Jerry’s head is pounding. For
five-and-a-half hours there has been turmoil. It will be another eleven
hours before he is relieved by other workers. ‘All my hard work is
merely stopping this place from disintegrating,’ he thought. ‘Surely
this is not why I applied for
this type of work.’ Jerry feels alone. He has no idea what he will do if the residents are unco-operative tonight and give him a hard time. Other jobs and professions suddenly seem more attractive.
Reflection on the foregoing incident with Jerry, the apocryphal and yet surprisingly real group home worker, leaves one with a sense of chaos, a state of affairs characteristic of this line of work now that the so-called profession of residential and day care has come into its own. The profession’s foundations have been built on shifting sands of change. Until the last decade or so, many child care establishments were run on the notion of a husband or wife, or both, managing a group of children virtually singlehanded as house-parents, with the assistance of cleaning staff, laundry maids and the occasional relief worker. The philosophies, ideologies, and values of child care were integrated within that husband and wife as house-parents, or in some particular individual who worked virtually every hour of the week. Thus, while the philosophies, ideologies, and values used by the house-parents might be judged by others to be right or wrong, simple or complex, rigid or flexible, the essential merit in this arrangement was that each resident was confronted with a single set of attitudes and values that were both consistent and enduring. When these particular philosophies and attitudes were in tune with and matched the needs and characteristics of a particular child, then progress was likely to be seen; where there was a mismatch, the successes were less common and transfers to other centres were a frequent result. Group home facilities such as these were advocated in the United Kingdom in 1946 by the Curtis Committee which envisaged the establishment of family group homes, preferably run by a married couple, where children could be closely in touch with the experiences of everyday life. The woman was expected to ‘play the part of a mother to the children, while the man must play the father ... [pursuing] out of door recreational activities rather than physical care of the child’ (Cmd 6922).
Today with the vast increase in numbers of child
care staff and supervisors working in group care settings, there is some
comfort in knowing that somewhere amongst the differing philosophies and
attitudes of staff, a child is likely to find someone who understands
him and who is on his wavelength. On the other hand the provision of a
coherent ‘parenting’, ‘teaching’, and
‘developmental’ programme is a complex undertaking as with, for instance, twelve children and six child care staff. The exercise becomes an organizational, managerial, and therapeutic nightmare! More often than not, what happens is that a collection of different types of worker, with marked differences in personality and values, become responsible for a collection of different types of children with a variety of problems. Together these two groups interact in an environment where all too frequently the philosophies, assumptions, approaches, and styles have not been clearly determined. This problem is the curse of residential and day care services for children; and indeed the curse of the helping professions when several different persons have to work together to provide therapeutic interventions for a child and his family.
Disparity amongst workers
Senior managers in residential and day care services frequently comment on the number of people who apply to them for employment in settings for children, elderly, mentally handicapped, or mentally ill people, even when no vacancies have been advertised. At interview these job applicants will emphasize that what has motivated them is their interest in working with people; they have something to offer to residents; they have always got on well with children, adolescents, elderly, or handicapped people; and they want to do something meaningful with their lives. In the main, the majority of these people are untrained.
As the interview progresses, it is common practice to ask for specific information about how the applicant would view a particular situation and what his/her response might be. A typical answer is, ‘It depends on the circumstances, and what I find to be best at that particular moment of time. It will depend on who is involved, what is the background to the problem and what is expected in that particular establishment.’ A response such as this suggests that the applicant is interested in using personality, beliefs, attitudes, and intuition to help persons less fortunate than himself/herself. Personality and beliefs are in their own right a product of personal background, upbringing, and experience. It may be that the applicant wants to apply his/her own skills and knowledge, his/her own relationship abilities, and his/her own uniqueness to work intensively with a particular group of children, using the programme elements available at the centre in which she/he could be working. But, in more sophisticated language, the applicant will be expected to use personality — still the product of genetic make-up and upbringing — in interactions with children, whether these have an impact or not.
When recruiting and employing staff for group care settings, what is the hirer looking for? Consideration will be given to values, personality, mixture of rigidity and flexibility, dogged control versus negotiation, permissive approaches versus detailed surveillance, and so on. Without a definite profile of the type of person best suited to working in a particular group care centre or agency, then recruitment involves an intuitive and possibly prejudicial approach to hiring staff. Decisions are based more on the characteristics of the hirer than on the traits of the employee. Some hirers’ track record for recruitment is excellent, while others’ records are abysmal when considering the length of service of those they hire, the candidates being able to manage the job and their ability to work as team members. Some people are good at hiring men but do a poor job with women; some are excellent with basic grade workers but second-rate at employing supervisors.
Thus, in group care settings there will be a range of staff from different backgrounds, with different values, different parenting experiences, different religious principles, different sexual mores, different hygiene habits, dressing and grooming practices, different nutritional ideals, and different eating habits. In summary, an establishment with six workers will tend to be a place where six individual workers come together to work with a group of children, with a spectrum of philosophies, practices, and behaviours that will be varied in at least six different ways.
If one person had been responsible for hiring these six workers, then it may be easier to detect a pattern in their characteristics; it is more likely that one would find people with certain similarities included and those with other traits excluded. The frequent pattern is that several persons have had the responsibility over months or years for hiring staff for a particular establishment or group of establishments. Thus, the differences and heterogeneity will probably be greater and values, ideology, and morals will frequently be in conflict amongst workers at the shop floor and at the level of shop floor supervisors.
It can be argued that the attitudes, energies, and optimism of each staff member is the critical influences for maintaining ‘Good Order’ in an establishment; for stimulating children to interact with each other, staff, and outsiders in a positive way; and for making definite progress in a planned direction. Based on these unique personality features, the group care worker assesses the crucial elements of treatment, makes decisions about the children’s group and specific treatment plans for individual children, and imposes sanctions on behaviour within a given set of procedures. This personality quagmire, the coherence or lack of coherence between staff members, would seem to be the main element which influences the success or failure of routines, intervention methods, and planned activities that surround a child’s total working day. Unless staff have organized themselves into a cohesive team, with an integrated climate which absorbs the different ideologies, values, and philosophies, then the energies of workers may go into surviving or just competing with each other, virtually ensuring that no treatment is accomplished.
Taking into account the complexity of practice and the number of personalities involved, let us return to the picture of Jerry doing battle in his group care centre. Immediate questions that are posed include:
How can a centre deal with a host of unanticipated eventualities, but in a way that is predictable and planned?
How can a group of staff, working shifts with no more than one or two workers on duty at a time, maintain a particular intervention approach for a particular child — whatever the circumstances?
Or, to use Henry Maier’s (1981) imagery, how can the best or ideal rhythm for a specific child be learned and practised by the group care worker in all interventions, resulting in the unity of rhythm between staff member(s) and child?
Furthermore, how can a centre draw together a diverse group of workers into a cohesive team which can affect the lives of a diverse group of children?
Some of these questions can be answered by having a clear statement of intentions within a specific group care establishment. The following sections examine a step by step approach to formulating an ‘Action Plan’ for group care practice.
Developing an action plan: strategic and practical considerations
An Action Plan seeks to define a care and treatment programme with children. It details specific actions and establishes clear boundaries within which certain types of action will take place. It describes the children with whom the centre works and the norms and culture of the staff. Logic first dictates a dear knowledge of the people for whom the programme is intended. Thus, prior to the development of any residential or day care setting, it is essential to know something about the existing children and those anticipated in the future.
When group care workers are asked to describe the residents with whom they work, some of the most frequent responses include: sex, age, criminal offence active/passive, co-operative/unco-operative, violent/victims, clever/stupid, runaways, impulsive, thieves, cheats, substance abusers, liars, fearful, untrustworthy, people with life scripts about never being close to others, not being successful, not being sane or well, or not being happy. Frequently these descriptions revolve around a child’s behaviour. There might be half-a-dozen positive descriptions and a dozen negative descriptions concerning any one child. Psychological, psychiatric, and educational reports produce some other descriptions for the same child. However sophisticated, the labels have little bearing on day-to-day interactions between staff and child. Indeed, with twelve children in a residential unit there would be an overload on any one worker if he were to remember all the assessment statements concerning all the children. Such statements and the implied responses are seldom helpful in a windowsmashing episode, a refusal to go to bed, a scapegoat incident, or one involving damage to a staff member’s car. At such times the group care worker’s natural, intuitive, and personality-induced responses come to the fore. If the problem is resolved then the worker will be looked upon as being competent, whether or not the diagnostic description and implied treatment strategy have been adhered to in any way.
Hoghughi (1980) described the usefulness of a diagnosis and treatment description for problem children. All considerations were thought to be subservient to the usefulness of assessment in order to meet the objective of alleviating a child’s problems. David Hunt (1972) has written about the same problem experienced by teachers in school. Hunt (1966) proposed a set of conditional statements indicating the environmental conditions thought appropriate for a child of a specified state in order to produce a sequence of change which was aimed towards a desired state. The crucial issue involves whether workers are able to make use of such information on most occasions and under most circumstances. This is quite different from the diagnostic approach which a psychotherapist might hold in his mind at a bi-monthly outpatient clinic. Here, the psychotherapist is likely to be in charge and his background, uniqueness, and idiosyncracies are integrated with his approach to treatment, which he alone puts into practice every two weeks. When more than one person is involved in the therapy then approaches need to be understood by each participant, so that each response a worker gives is integrated with shared attitudes, philosophies, and practices.
Brill, using the Conceptual Level Model (1977), demonstrated that in some situations group care environments can be specifically designed to give children differing amounts of ‘structure’. Conceptual Level is based on a theory of personality development (Harvey, Hunt and Schroder 1961), where the stage of development for a person — whether maladjusted, delinquent, or normal — may be assessed. Where a person is located on this developmental continuum indicates his Conceptual Level, made up of cognitive complexity (differentiation, discrimination, and integration) as well as interpersonal maturity (increasing self-responsibility). A person with a higher Conceptual Level is thought to be more structurally complex, more capable of responsible actions, and more capable of adapting to a changing environment than a person at a lower Conceptual Level.
Brill’s research was based on the Conceptual Level of each child placed in two different residential units. These units were designed with different amounts of predictability, consistency, staff control, order, and organization, doing tasks alongside children, tangible reinforcements, opportunity for expressiveness, emphasis on personal problems, autonomy, and so on. Children of very low Conceptual Level did better in the higher structured residential facility and had fewer problems in terms of time being spent in detention or absconding from the programme. These results compared favourably with the results of children with very low Conceptual Level placed in a unit where the environment was less ‘structured’ and less organized by staff. Those children whose Conceptual Level was low, as compared with very low, did slightly better when the amount of ‘structure’ was reduced in small quantities. In short, the mismatched, low Conceptual Level boys in residence had more than two times the problem behaviour incidents of those matched to the programme in which they were placed in terms of precision, consistency, directiveness, and structure of that unit. Also the time spent out of ‘programme’ (in their room or elsewhere) because of unacceptable behaviour or because of absconding was three-and-a-half times greater for the mismatched children than for those matched.
Brill and Reitsma (1978) further discovered that if the Conceptual Level of the primary worker (the key person in charge of coordinating the care and treatment plan for a child and providing most counselling time with him) is one stage above that of the child in Conceptual Level terms then development was apparently heightened, and change in a positive direction was most obvious. In addition, Brill and Reitsma found that according to another differential treatment model — that based on Interpersonal Maturity Level (Grant, Grant, and Sullivan 1957) — if the primary worker was matched by his personality to the needs and characteristics of the child, then progress in a residential establishment was significantly greater than for those children not matched or completely mismatched (Palmer 1967, 1968, 1972).
In short, Brill and Reitsma found that when there was an optimum match between the resident and the key or primary worker, using the Conceptual Level Model, then residents spent one-third less time in residential care and had one-half the rate of problem incidents than when there was a mismatch between resident and primary worker. Yet again, when the primary worker was matched to the child, according to Palmer’ s I-Level matching criteria, these residents had one-eighth of the problem incidents and only 2 per cent of their time in residence was spent out of programme. This is compared favourably with the mismatched primary worker where residents had eight times as many problem incidents and 25 per cent of their time in residence was spent out of programme. The importance of this is that both the Interpersonal Maturity (I-Level) and Conceptual Level Models provide typologies from which to develop differential treatment environments for different children. A great deal is known about which type of staff member will work best with which type of children and in what type of programme. There is also a good deal known about what basic techniques are best used with different children.
In summary, our starting point was the chaotic set of crises encountered by Jerry the care worker. It is possible for Jerry to achieve greater clarity as to how he should try and deal with each situation that confronts him. It is possible to know more clearly what type of residents are normally placed in his unit, with the obvious implication this has for any type of intervention. Appropriate recipe(s) for particular groups of children can help maintain Jerry’s sanity and motivation, while assisting the children themselves to progress on to more complex and responsible behaviour. Then the ‘dynamic’ characteristics of practice in a unit necessitates the monitoring of children’s progress to keep track of what developmental changes take place over their period of placement in group care. As the make-up of the resident group alters over time, so the Action Plan of the care establishment will change in fairly precise ways, because of the characteristic patterns of interaction between particular children and particular environments to produce planned results. Hunt stated, ‘The issue is not which environment is best, but rather which environment is best for a particular person to produce a specific effect’ (1972: 17).
In the same way that a child’s developmental stage is regularly assessed, so it is equally important to monitor what is happening between staff and children, and between different children. It is necessary to assess whether the action plan is really being put into practice or whether aberrations and numerous exceptions are the order of the day. Finally, the tasks of monitoring child and centre characteristics should be balanced against an evaluation of the programme as a whole. Here the results may be compared with evaluations from other places using the same practice language concerning children, care and treatment environments, and programmes. Frequently the central question involves asking, ‘What kinds of children are participating in the group care service, under what circumstances, and what does that imply for management and treatment?’ (Warren 1973).
Section 1: Social policy mandate and philosophy of the centre
(a) The definition of centre mandate
So many are the variables concerning children, staff, programmes, strategies, and even length of time in care, the arguments so recurring about what approaches work best, that optimally many decisions about programme design, general philosophy, and methods of working may need to be taken outside the group care unit. The leaders and those already working in a setting, if they have already been hired, make representations to managers or administrators about their views on child assessment, prescribed actions, and broad outlines of intervention. It is clearly advocated that decisions such as these about mandate should not rest with the team leader and his immediate staff group alone. Frequently such important decisions are left to team leaders because an agency has no coherent way of describing children or staff programmes in an integrated whole. Care and treatment goals are frequently written in vague, ‘fuzzy’ terms (Kushlik 1975; Mager 1972) such as ‘realising a child’s potential’, ‘broadening experience and skills’, ‘increasing self-confidence and ability to make relationships’, or ‘to aid insight into self-defeating processes’.
What is unhelpful is the realization that most group care centres adopt such statements as basic beliefs or as an accepted part of their service claims. The British Association of Social Workers (1977) in the opening pages of its document defining ‘The Social Work Task’ offers an example of how ‘fuzzy’ language (Mager 1972) is adopted by a professional body. A mandate written in such global terms, with words likened to a belief system, is not helpful for a team of workers who require clarity of expectations about the fundamental direction and ethos of their programme. A mandate written in global terms can lull an agency into the false impression that it actually has detailed direction for its various programmes. However, when many programme descriptions are examined closely, frequently one finds that no integrating formula holds the scheme together: neither the care and treatment strategies for particular children, the characteristics and traits of staff needed, nor methods for systematically monitoring and evaluating change.
To summarize: chaos and disillusionment are more likely to exist and be in evidence unless there is a statement of policy expectations or mandate about what kind of children the programme will serve and general ideas about the treatment strategies expected. Those working in group care programmes might well ask themselves: (1) What is the policy mandate for our present work setting? (2) Who decided these expectations? and (3) What are the concepts which underpin the policy mandate and what assumptions are used to integrate children, staff, and programme? Asking staff to write down their individual answers to these three questions and then asking the staff group to examine their replies during a team meeting provides its own revelation of similarity, difference, and confusion.
When setting up a new service, a team leader may well have the luxury of working out key areas of the programme prior to hiring staff. If the staff group are already in post, as happens in most establishments, an effective tactic which can assist staff to develop their work occurs naturally through the developmental process which an action plan uses. It evolves from within the staff group, under the clear leadership of the team manager, and seeks to use the aspirations of each staff member. Minimum requirements are that the team leader needs a knowledge of group dynamics and the workers should not be totally inexperienced at working in staff groups where, at different times, the members may be challenging, confronting, intimate, and revealing. If the majority of a team have little knowledge of group dynamics and the steps through which groups develop and regress, then the action plan exercise may get bogged down with interpersonal problems that get in the way of its primary task. Menzies (1977) referred to this as anti-task activity. If it happens, then the team leader needs to acquire (or needs to be instructed about) guidance in group dynamics, sensitivity training, or something similar.
(b) Philosophy of the unit
To be realistic, it must be remembered that an action plan provides detailed statements on the whole variety of aspects of group care practice, a centre’s rules, resident group culture, staff, and so on. It is not a solution and decision-making print-out of every variable likely to confront a worker in the course of a shift. The action plan is used to clarify issues about the establishment’s philosophy and beliefs, the principles underlying child management practices, communication approaches, and aspirations. When these issues are clearly articulated and written so as to be understood and endorsed by all who work in the centre (or in association with a centre), so there develops the basis for a shared approach to practice. Real differences and individual preferences amongst staff members will be highlighted during what can become a longdrawn-out process of coming to a negotiated agreement about a shared language of practice. Conflicts emerging in relation to different orientations, backgrounds, experiences, beliefs, and lifestyles are essential steps in the development of an Action Plan, and also the level of commitment to the plan which is likely to result thereafter.
At least three questions need to be asked of staff as they engage in this step of the Action Plan process. It is comparatively easy for all workers to give initial responses to these questions separately and in writing, in a task involving about 5-10 minutes. Staff members are asked:
What are the guiding principles which underlie the work of this centre, its work with children, staff, neighbours, and other professionals?
What ideas or concepts are used to explain the unit’s work with children?
Describe in a few words the communication or interpersonal approach used in interactions between staff and children, between children, and between staff.
This kind of written exercise is frequently a stimulus for people to take such a ‘fuzzy’ or ideological question seriously. Responses from staff in different units are given as examples:
No responses at all were given, with workers unable to formulate a written statement of philosophy for themselves, let alone a philosophy that might incorporate principles for the whole unit. In such a case, specific instruction, experiential work, and clarity of thinking were necessary in order to get the workers to think in terms of philosophy.
Clearly articulated statements which were in conflict with the statements of other workers. Such statements were products of the different backgrounds from which the workers had come as compared with a common definition about the resident group.
At different times in a very short period, the same workers answered the three questions very differently, revealing the temporary nature of the centre’s philosophy. Statements that are based on the past few shifts of work are often presented in subjective terms.
A coherent, systematic response was obtained from a fourth team, indicating the successful completion of important groundwork which was necessary in order for workers to perform with a shared approach to practice.
Section II: Child development and orientations to group living
(a) Child development
This section outlines the particular features involved and events that take place in the centre which give the setting a uniqueness. This involves such items as:
influencing children’s group culture;
transmitting values to children;
children’s rules and procedures;
The team leaders are encouraged to make certain that in thinking of child development, the subheadings of an Action Plan will reveal important norms that may be distinctive features of the centre. Not everything taking place with children needs to be mentioned, otherwise the Action Plan document will be so large that it cannot be used as a staff guide or handbook.
In a way similar to that which was detailed above concerning philosophy, benefit can come from asking individual workers to spell out in writing what they consider to be the ideal culture initiated and enacted by staff with children in the centre. Writing this up on large paper and posting it around the wall (wallpapering) offers an insight to everyone about the common and divergent attitudes held by staff members towards the children. If the unit is already functioning with children, each worker can also be invited to write how they assess the present children’s group culture. Comparisons between the ideal and present group cultures are important and frequently result in productive discussion. Different strategies for influencing and having an impact on children’s group culture are readily available. Jones (1968) advocated a participative approach, Vorrath and Brendtro (1974) outlined a peer responsibility approach, while Brown and Christie (1981) or Pizzat (1973) have offered social learning approaches to practice. The basic philosophy of the centre — already completed — must be compatible with and reinforce the key interventions planned with a group of residents. Feedback from workers who have struggled with these two sections in an Action Plan has revealed that these sections are frequently the least tangible of the lot. They are the most difficult to sort out and yet the most important, because all other aspects of the Action Plan build from a coherent statement about the centre’s philosophy and its orientation to the children’s population it serves.
(b) Values and attitudes to child behaviour
Once the basic orientation to work with children is clear, and the workers have clarified major expectations which they have for the children, then a series of more specific questions need to be asked. A highly relevant, but seldom asked, question for all workers is: What are the specific values that we want the children to leam?
In practice this question can be considered with staff, using an exercise similar to that already described. At a staff meeting, workers can be asked to ‘Write down six basic values you want children to learn.’ Such an exercise can demonstrate, in a reasonably relaxed way, the important differences in social background which exist between workers, and therefore different priorities given to teaching children. The individual value preferences can be wallpapered around the wall, giving staff an opportunity to note whether their recommended values are acknowledged. Various patterns have been highlighted as group care workers have engaged in such an exercise:
Some staff have similar values.
Some values may be wrapped up in a personal language which disguises the basic value, and to which several other values can be imputed. Many workers hold the value, for example, that ‘residents should attend a dentist every six months’. Here the value is not seeing the dentist but perhaps ensuring that a child keeps his/her teeth for a lifetime or maintains his/her good looks. Alternatively the worker may be saying, ‘I don’t want you to have to suffer a lot of dental work, therefore it is better to do something each day than it is to wait until your teeth rot,’ in other words a stitch in time saves nine.
Some values held by workers are total absolutes, such as ‘always tell the truth’, or ‘telling the truth in certain circumstances’. Does telling the truth mean truthful replies only when asked a question, and does it include voicing opinions when someone expresses dislike or revulsion — as when seeing a dirty, intoxicated man asleep in a chair? Such absolute values, and how they should be applied in a given setting, are opened for debate amongst workers.
Workers tend to find absolutes and procedures easier to recall than to identify values which they might find helpful to reinforce with children in day-to-day practice.
Group care teams are encouraged to refine a half dozen social values which the workers’ group can reinforce over and over again, during any shift, whether events go well or badly. In so doing, a group care team helps to promote consistency and enable children to assimilate learning through repetition time and time again. This is especially relevant for egocentric, impulsive children whose interests are solely in the present. It is also helpful for those who have surges of emotion which dominate mind and body.
When value orientation has been considered, on both sides of the Atlantic, some workers have objected to the notion of filling children’s minds with a particular set of ideals. Such an approach has been thought contradictory to the notion of individual freedom. These workers want to emphasize values where children are allowed to pick and choose for themselves and change their own values.
To counter these arguments, proponents of the Conceptual Level Matching Model have shown that a large proportion of residents in some centres have not become dependent on any clearly defined norms or values. For this reason, until personal values become part of a child’s pattern of functioning, it is neither appropriate nor possible for that child to start being independent or commence working out his own beliefs. Brill (1979) highlighted the importance of flexibility in negotiation and expressiveness in work with children who had internalized personal values. However, approaches such as these have often been misused with children who are physically mature, but whose egocentricity is extreme and whose interpersonal maturity is low. Brill and Reitsma (1978) demonstrated that significant behaviour problems come about as the result of staff wanting young people to work out their own value systems. Such findings serve to reinforce the argument that group care workers all too frequently use idiosyncratic approaches in their practices with children.
Relevant values for egocentric children might include the following:
Stop and think (before acting or responding).
Listen to what others say.
Do unto others as you want them to do to you.
Face up to others.
Face up to problems.
Your views and ideas are important.
Group care workers seem to have little difficulty considering what these values might involve in practice. They also tend to support decisions about using all happenings, whether positive or negative, to emphasize these value prescriptions with direct suggestions about their importance. After frequent use and practice, the workers may start to use indirect suggestion by telling stories or using metaphors which contain these values (Grinder and Bandler 1979; Lankton 1979).
(c) Rules and expectations
Workers will have to decide what to include in this section and more important what to miss out. A statement of all rules and expectations will be so huge and overpowering that it will alienate most children, staff, and others. Procedures and rules can include the daily routine or timetable with specific indications as to when events occur. Important expectations and rules can also be included, especially those that are fundamental to the smooth functioning of the establishment along certain lines. Some rules come to the forefront of the mind because of contravention on a regular basis, and others because, when broken, these rules cause difficulties for staff.
Basic expectations can be spelled out around daily living routines, including:
Chores, details, or daily jobs.
Leaving the centre, weekend or holiday absences, absconding, and so forth.
Formal or informal counselling sessions.
Pocket money and other.
Rules might include statements such as:
No violence against any person.
No drugs or alcohol.
No visiting each other’s bedroom after 9 p.m.
No sex on the premises.
However much effort workers put into spelling out rules, most of them are likely to be written in negative terms. Some centres have stated the penalties which will be imposed for non-compliance with expectations or violation of the rules. Other centres have tended to reinforce daily compliance. Still other centres have been known to bring violations to a regular group meeting.
Putting only basic rules and expectations down on paper often results in the claim made by some outsiders that more rules and expectations should be written into the Action Plan. Ultimately the decision about what to include will necessitate each group care worker listing all the rules and expectations as they see them in the centre, and then everyone rank ordering their importance. The revelation that comes from workers through such an exercise is that different staff see norms, rules, and expectations differently. Some rules and expectations might apply with some members of staff, while others might operate quite differently. For example, it may be discovered that some workers have a rigid approach to ensuring the children go to bed at the stated time. Others, however, may allow television to be watched until the end of a programme, or until activities have been completed. The smaller the unit with fewer staff working alongside each other, the more likely it is that very different procedures will evolve for different shifts. Again using the evidence supplied by Brill and Reitsma (1978), and that of Hunt (1972), the more egocentric and lower the interpersonal maturity of a child, the more learning approaches should emphasize systematic and consistent interactions throughout his waking day.
The very fact of consolidating rules and expectations in workers’ minds will force them to clarify particular demands or prohibitions used in their centre. The end result for an Action Plan is that while numerous agreements will be made concerning basic prompting and general compliance from residents during certain events, only a few rules will actually need to be written down. Otherwise, the list becomes never ending and forever changing. A crucial function at staff meetings is to review and update rules and expectations at regular intervals for everyone’s benefit!
Section III: Links with family, peers, and significant others
(a) Family development
Questions posed in this section involve the centre’s approach to working with families. Here, workers are invited to consider the attitudes that are held towards involving parents in the life of the programme. For instance a particular group home had a clear objective about intensive work with parents. This objective was written into their social policy mandate by the agency which funded them. Basic expectations concerning work with families were stated, involving at least two contacts with the family by each worker each week, with at least one of these meetings being at the group home. A specific contract was to be negotiated with the parents at the time of referral. Any home visits would be followed up by detailed discussion so as to examine how the visit had gone. Parents were actively encouraged to use the same techniques with their child at home as the group care workers were using, most frequently a Behaviour Modification approach.
In other establishments, contact with families may be less intensive. Whatever the level of contact, it is important that practices carried out with families are clearly stated and workers know what actions are expected of them in this respect. If the philosophy and attitudes underpinning practice are to ensure that parents become partners in helping (Whittaker 1979), ther the methods which are used to engage parents as partners will need to be stated. Conte explores this practice issue further at a later stage in this volume. It is worth remembering the evidence supplied by Taylor and Alpert (1973) who found that, more than anything else, the determining factor about future adjustment following an institutional care placement is the frequency of contact between parents and child.
(b) Involvement of peers and others
The friends and associates of children will inevitably have contact with a group care centre. Whether school friends or work mates are concerned, the Action Plan should make a basic statement about how these involvements should be managed. Parties in the early morning hours, under-age drinking, or sexual involvements give some indication of issues that might develop. Involvements with other ‘outsiders’ should also be noted whether these include health and social service workers, police, neighbours, shop deliverymen, volunteers, or others. This subsection of an Action Plan is rarely complete. Rather, workers are required constantly to upgrade their involvements with others in practice.
Centre workers are asked to consider their relations with children who have left the centre and gone elsewhere. Any contact which is planned or engineered to provide continuing encouragement and support for ex-residents should be stated. Sinclair (1971) and Moos (1975) have argued that basically adjustment to living outside a group care centre is correlated with the after-care environment that a person will be living in. The implication is that a child is more likely to succeed with any social skills taught in a group care centre if those prompting these skills in an aftercare environment include the people who have struggled with him/her in close proximity during previous weeks and months. Of course, if this is to happen, it may only be possible when those using a centre live in close proximity and have few problems concerning transportation. This step in the Action Plan process enables numerous changes and adjustments to be made, and identifies practical ideas about after-care which could become part of the service.
Section IV: staffing and staff development
A summary statement about how the staff function together as a team, including reference to the consultation and supervision available, is very different from the statements made in the child development areas. In itself, this section can be brief. There is opportunity for a team leader and team members to expand or contract the Action Plan headings to suit the particular orientation
of the centre. The issues referred to here give an illustration of what could be expected in some settings. It is interesting to note how people identify subjectively with the notion that what happens within the staff group is often reflected back in what happens with the children. Thus, the level of energy available in a team, its commitment to interpersonal and intra-personal development, the workers’ orientation to staff meetings, availability of consultation and supervision: all contribute to the morale, satisfaction, and effectiveness of group care workers.
In writing on this matter and his use of the Group Environment Scale (Moos, Meel, and Humphrey 1974) to assess team climates, Brill indicated that a moderate level of Leader Control appeared to be a necessary, but not all-sufficient condition for efficient team functioning. It would seem that Leader Control should be combined with (1) a high level of organization and clarity around daily norms, expectations, and routines, and (2) teamwork to minimize workers’ loss of energy through frustration and anger, and to maintain a high task focus. Under such conditions, it is expected that staff morale would be higher and rates of turnover considerably reduced (Brill 1979: 120-23).
The corollary to this is that an inefficient series of staff meetings, no predictability around consultation and supervision, or a lack of clarity about who does what, when, and how, are likely to be reflected in low morale amongst residents, more behaviour which is out-of-control and more complaints about the handling of different situations. Thus it is that a brief section about care for the care-givers is an important feature of any Action Plan. As Maier argued, ‘It is inherent that the caretakers be nurtured themselves and experience sustained, caring support in order to transmit this quality of care to others’ (1977: 17).
(a) Staff meetings
Some statement should be made about the frequency of staff meetings and who is obliged to attend. This would influence the rostering of staff. If different people attend for different sessions this is likely to alter the way in which meetings can be conducted. Action plans can spell out expectations about staff meetings using short statements concerning the organization of each meeting and how this reinforces the philosophy of the unit. Increased efficiency and positive feedback about how time spent in meetings has become more productive is the consistent response from workers using this approach. Workers seem to be especially pleased with the increased cohesion which is reported in relation to work with residents and in planning for the future.
(b) Staff consultation and supervision
The Action Plan should note how an establishment stands with regard to the team leader providing a formal consultation and supervision service. If a unit is committed to such a service, the Action Plan needs to spell out how it will be conducted. This contrasts dramatically with a team leader and staff meeting simply because of a perceived obligation and without clarity of purpose and organization. Such ad hoc, unplanned meetings are so frequently time wasting. The system of staff consultation and supervision, spelled out in an Action Plan, might involve:
a review of previous decisions;
a review of key worker activity;
the health, job satisfaction, and morale of workers;
fulfilling the tasks of the job;
any other business;
a summary of decisions taken;
an evaluation of the meeting.
The Action Plan might make formal note of the importance of consultation by specifying a minimum number of meetings per month and obligations associated with taking notes at meetings. An alternative route is to ensure that a meeting is never adjourned without setting a date for the next session.
Section V: Key worker responsibilities
An aspect of group care practice which is becoming increasingly common involves a direct care worker co-ordinating all aspects of care and treatment for a particular child. Such a worker also disseminates information about that child to all other staff. In some places this person is termed the ‘primary worker’, in other places this person is called the ‘key worker’. If such a system operates, then the basic responsibilities of a key worker need to be spelled out in the Action Plan, describing how the key worker will carry out these tasks. This might include planning care and
treatment activities, report writing, liaison concerning job finding or school attendance, formal counselling sessions, working with family, and so on. An Action Plan seeks formally to incorporate this feature into the overall service.
Section VI: Evaluation of staff performance
Another important area in the Action Plan involves specification of how performance and actions of each worker will be monitored and evaluated. An Action Plan with clear philosophy and procedures will be a waste of paper unless there is clarity around evaluation of staff performance. It is important for a team leader to be involved in setting up a recording system which can monitor how each worker is performing. Thus, a clear record of performance can be used to focus discussion on actual practices at staff meetings, individual consultations, and during in-service training sessions. Without this section being clearly articulated, there is no definite reason for workers to conform to the Action Plan. A useful exercise involves staff being asked to identify in writing those practices which they believe are going well, those which are unproductive, and those which are likely to need oversight in order to guarantee consistent performance. It is a frequent cause for surprise that many workers request an inspectorial approach so as to improve their own individual performance and to enforce changes in the performance of others.
Section VII: Programme development and evaluation
This final section is oriented towards examining what happens over the course of time with children, the group care workers, and the setting. Whatever the major interests of the team, these will be reflected in the information collected.
(a) Resident change
Some centre teams are oriented towards looking at criminal activity, violence, and problem incidents while the child is in residence. If this is so, then the Action Plan should state how the required information is collected. Such information might also include the rate with which children are unfavourably discharged or removed from the centre. Others might be interested in overall changes experienced by a child during his time in receipt of services, so diagnostic testing at the beginning of his stay would be replicated at pre-determined intervals. The increased demands for care and treatment accountability make this issue of service evaluation a very important consideration in any Action Plan for practice.
(b) Unit environment
Only a few programmes look at evaluation measures concerning a centre’s environment. The environment scales developed by Moos (1974, 1975) can be used to assess the environment of group care along nine comparative dimensions, irScluding the Relationship dimensions of involvement, support and expressiveness; the Personal Development dimensions of autonomy, orientation, and achievement; and System Change dimensions of order and organization, clarity of expectations, and control. This is done by using a questionnaire completed separately by each worker and resident. The information obtained from such environmental analysis enables future development of the service. For instance, with low Conceptual Level adolescents in an institutional setting certain environmental profiles would seem to enable the establishment to run most smoothly (Brill 1979). If more mature people are in residence, then other profiles are necessary. Chase (1973) correlated certain environmental patterns that went with a reduction in absconding, where less absconding was found in environments with reasonably high staff control and a high emphasis on expressiveness by both staff and residents. Such findings further emphasize the importance of systematic evaluation in group care practice. It is on this basis that the Action Plan and future development of the service can proceed.
(c) Information about staff
Finally, it is important to consider the information about staff which might interest a centre. The rate of staff sickness in a centre is an important consideration. In recent years there has been a growing interest in job satisfaction and staff morale, and changes or trends in satisfaction and sickness which take place over time. If these issues are important to workers, then a monitoring of basic information about staff attendance and performance may help to reduce the amount of sick leave in a centre. High levels of sick leave frequently put heavy demands on other workers who can have their hours increased with little warning. This, in itself, can influence job satisfaction amongst team members, as demonstrated in a study of group home staff (Johnson et al. 1978) where those working in excess of fifty hours per week were more likely to report symptoms of ‘burnout’ and feelings of despondency. The opposite results may be found in teams where workers concentrate on staying ‘well’ and dealing with practice issues as they emerge.
A shared language for practice in group care has been suggested through the development of a centre Action Plan. It is not intended that all the features suggested here should be dogmatically adhered to by those seeking to develop an Action Plan for the first time. Rather, they are offered as examples which illustrate the Action Plan framework. A range of exercises have also been suggested which can enable workers to produce a coherent statement about how their service will operate.
Certain assumptions have been made throughout this chapter about the
importance of a common theme that draws together the disparate
characteristics of children, treatment environment, and intervention
strategies. The Action Plan is intended to be a negotiated statement of
common themes which tie people and programmes together. In so doing, an
Action Plan can help workers to reduce the level of conflict,
competition, or despair which can all too easily develop in daily
practice. Since the development of an Action Plan involves a team
process, it is likely to increase the clarity of focus expected for each
worker. The completed document is also useful in public relations with
other professionals and referral agencies.
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This chapter: Casson. S.F. (1985). Developing a shared language and practice. In Fulcher, L.C. and Ainsworth, F. (Eds.). Group Care Practice with Children. London and New York. Tavistock Publications. pp. 75-106.
*This is the ninth in a new series of chapters which the authors have permission to publish separately and which they have now contributed to CYC-Online. Read more about this program.