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23 January
NO 1255
Psychodynamic care work
If staff are to work with the emotional and intellectual intensity which those looking after Roland were attempting to achieve, then there are implications for the recruitment, management and training of staff. Working psychodynamically is complex and requires staff to have both intellectual and emotional insight into what makes a relationship. This can only be achieved with self-challenging training and supervision. The resource implications of this may in part explain why those responsible for the management of caring services resist the psychodynamic approach.
Human beings do not necessarily fit into prescribed categories or to prescribed short-term and narrow treatment programmes. Yet it can seem that the wider community has a need for something to be seen to be "done". Short-term finite solutions can be a dubious panacea which gratifies an unacknowledged general need of the wider community to feel that it is in control of troubled young people. The other side of this coin is the unconscious infantile terror of being out of control. Acting out this societal 'counter-transference' achieves as little in the wider community as it does in the smaller world of the children's home. For staff in the unit, it can seem that the communities responsible for placing young people have decided that they can do nothing else with them. In this extreme situation, psychodynamic approaches offer staff the idea that there are times when it is better that nothing is `done' to or for a troubled young person apart from providing the space to heal.
Waddell (1985) examines the different stances adopted by social workers and psychodynamically-trained workers. She argues that the psychodynamic worker attempts to create a mental as well as a physical place, where time is given for young people and adult carers to reflect and have a space where it is safe not to know, (my italics) and room to process what is happening in their relationships. I would suggest in the current social work and residential child care cultures, such an approach is not valued because it is not seen as specifically `doing' anything and so challenges the `finite solution' way of thinking. Waddell reminds us that this kind of `doing' – always having a ready answer – is more about `servicing' a system rather than `serving' a young person.
A fundamental premise of the National Minimum
Standards is that good residential child care must be based on the
development of a stable, trusting relationship between a young person
and a caring adult (DoH, 2002). A relationship of this kind is
fundamental to the psychodynamic approach. Making a relationship is
complex and time-consuming. It is a process which requires commitment
from both parties if it is to be real. It needs time and space for
reflection, particularly when difficulties occur. While the S/NVQs
relevant to residential child care discuss relationships, they can read
as if a relationship is something that is `done' to looked-after
children rather than an acknowledgment of the mutuality of a
relationship. The training of residential staff, while encouraging a
reflection on the importance of relationships, could do better by
exploring these as complex mutualities which alter the behaviour of both
parties. It could be that some placement breakdowns in children's homes
are exacerbated by staff who may not be trained to deal emotionally with
the behaviour of children. This view has some empirical support in the
research of Heron and Chakrabati (2003). They explored the perceptions
of staff towards children in residential units and found that rather
than empowering residential child care staff in developing their
relationships with young people, those who drive current developments in
social work de-prioritise the needs of children by failing to provide
staff with training which addresses the real issues and problems, in
particular the relationship between child and worker.
CHARLES SHARPE
REFERENCES
Waddell, M. (1985) Living in two worlds: psychodynamic theory and social work practice. Free Associations, 10.
Department of Health (2002). National Minimum Standards: Children's Homes Regulations. London. HMSO.
Heron, G. and Chakrabarti, M. (2003). Exploring the perceptions of staff towards children and young people living in community-based children's homes. The Journal of Social Work, 3, 1, pp.81-98.
Sharpe, C. (2006). Residential child care and the psychodynamic approach; is it time to try again? Scottish Journal of Residential Child Care, 5, 1. pp. 52-54.
