NUMBER 1202 • 27 JULY • cyc practice as psychotherapy
The debate over what constitutes effective psychotherapy is at least as old as Freud, and while he is generally accepted as the first psychotherapist (Hubble, Duncan & Miller, 1999), it did not take Freud’s disciples long to establish their own brands of Psychotherapies (Corey, 1996).
The debate heated up in the 1950’s over claims by those adhering to a behavioral perspective, that talk therapies were not effective, and that to achieve public credibility, the effectiveness of psychotherapy had to be empirically established (Bachelor & Horvath, 1999).
By the 1960’s, when Child and Youth Care was gaining public credibility with the publication of Cottage Six ( Polsky, 1962), and The Other 23 Hours (Trieschman, Whittaker, & Brendtro, 1969), this debate, essentially was a fight between adherents to a psychoanalytic model and a learning theory model, had taken on the characteristics of a “holy war”(p.9). No small wonder then, when John Bowlby a psychiatrist himself, formulated attachment theory (Bowlby,1969/1982) which he saw as an attempt to better understand human development and that recognized concepts from both models, that he was immediately ostracized by the psychoanalytic community.
Child and Youth Care then, as a profession, has emerged within the context of this historical conflict and has contributed the idea of the therapeutic milieu to the discussion over what constitutes therapy.
Recent trends in the field of psychotherapy towards a managed care model of service delivery which emphasizes empirically validated treatments, the use of therapy treatment manuals, and protocol-driven interventions (Ogles, Anderson, & Lunnen, 1999) requires Child and Youth Care professionals to continue to speak eloquently to the therapeutic value of their work. While Child and Youth Care continues to be welcome in some fields of children’s mental health, and new opportunities may arise within the youth justice system, other Child and Youth Care practitioners have been laid off within traditional areas of Child and Youth Care employment such as schools, and within the Ministry for Children and Family Development (MCFD). Recently on the Sunshine Coast, here in the province of British Columbia, child care programs funded by MCFD have been drastically cut. The reasons given were that best practices research had shown that child care workers were not effective, the programs were too expensive, that child care workers did not contribute to healthy attachments for children, and that child care workers offered “recreation only”.
While I am not suggesting that improvements cannot be made to such programs, or that child care staff, like other professionals, require supervision and support to increasingly develop a vision of their work that includes a therapeutic focus, I am suggesting that any notion that suggests that quality Child and Youth Practice is not therapeutic needs to be vigorously rejected, and is not in keeping with recent outcome research which suggests the reverse.
Rayment, J. (2005). Child And Youth Care Practice as Psychotherapy. Relational Child & Youth Care Practice. 18(2), pp.29-33