It can happen with child and youth care workers that we fully understand the kind of kids we work with and the nature of the problems they bring with them ... but we don’t really want to see any of that right in front of our eyes. There may have been abuse and violence and stealing and acting out and manipulation, but we somehow expect all of that to have been left outside, and we react angrily and punitively if anything like that happens in our unit.

It’s rather like admitting a seriously ill patient to a hospital and then saying "Welcome to our ward — but God help you if you’re sick in here ... if you bleed on the sheets!"

Two of the required ingredients in Fritz Redl’s recipe for a treatment program were "symptom tolerance guaranteed, old satisfaction channels respected" and a "rich flow of tax-free love and gratification grants". Redl expected that while we would naturally protect others from a youth’s distressed and destructive behaviour, we needed to live with the hurt and rage and inadequacy in order to understand. (The word "therapy"– remember? – from the Greek therapeuo, meaning "to wait upon".)

Merely forbidding, suppressing or punishing, or worse, making our acceptance conditional on "good behaviour", do not help us to see what and where are the problems and the blockages and the needs. These reactions do little more than add to the feelings of frustration, rejection or guilt. If we only had to say "Stop it!" for there to be instant improvement, we would not have had to admit the youngster to our program at all.

And Chris Beedell warned that we should take care to "admit the whole child", warts and all, not exclude the bits we don’t want to see, if we are to come to know the young person we are working with. Any program for troubled kids will be filled with pain and doubt, anger and mistrust. Our work is that from within this mess we accompany kids to new possibilities, new ways of understanding, new ways of being with themselves and with others, new hopes and futures.

If you’re scared of the sight of blood, you shouldn’t work in a hospital.