NUMBER 949 • 25 APRIL •
residential
treatment centers
INDEX
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Residential treatment centers have always steered a course between bureaucracy
and anarchy. It’s in the nature of the work: the various state bureaucracies
that purchase our services must be sure we are safe and non-controversial for
their clients, but these same clients have had years of experience fending off
our sorts of help; for us to reach them we must be creative, even surprising, in
our interactions. Most residential treatment center directors are on the lookout
for better, newer, and cheaper programs, and the direct care staff are
idealistic and open to new ideas. Perhaps directors more easily accept changes
in physical plant and program descriptions than changes in administrative style
or direct care staff attitudes, but willy nilly, change is in the air. All around us we see the old bureaucracies breaking up and the shift of power-internationally, nationally, and in local militias. The states are lagging behind, but soon will be demanding new programs for youth. If we have trouble providing them it will probably be because we have slid into bureaucratic ruts, for example, in squelching surface behavior by point systems, rather than welcoming the “problem” behavior as an opportunity for engagement with the student, however anarchic that engagement may be. Currently there is much interest in changes in administrative structure, from traditional control based in hierarchies to what is sometimes called Total Quality Management (TQM), as described by authors such as Tom Peters (1992) and Chris Argyris (1993), books such as Managing the Residential Treatment Center in Troubled Times (Northrup, 1994), and journals such as Residential Treatment for Children & Youth and Child and Youth Care Forum. Applied to larger organizations, Total Quality Management implies decentralization, and applied to residential treatment centers, it proposes empowering the direct care staff, giving them more responsibility, initiative, and independent judgement. Carrying out this sort of organizational change can be tumultuous but in the end is usually inspiring to the staff and helpful to the students. Years ago I was a consultant to the staff of the first special education class in the local public schools. We were filled with the inspiration of a new organization, sure we would overcome local predictions of failure and reach and cure these students, retarded and psychotic alike! We did help them remarkably well, though in retrospect we had only the most general and expedient idea of what we were doing. I suspect something of this inspired energy can be seen in the enthusiastic style of the Total Quality Management authors. Thus, change is coming, and we can sketch one direction of change toward decentralization, in nation-wide social services, in the states (for example in purchase of services), and locally in the residential treatment centers. Less clear is what these future residential treatment programs should look like in detail, and how to plan for the interactions “where the action is,” between the direct care worker and student. Needed are concrete examples of successful programs with samples of the interactions between empowered staff and their hopefully empowered students. |
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