ISSUE 132 FEBRUARY 2010 BACK

PRACTICE

Supporting families: A school based child and youth care worker's perspective

Clarke Aubey

Through a case example, this paper explores the roles of a school based CYCC in supporting families. Those roles include crisis manager, counselor, family support worker, advocate, team liaison person and referral agent. Specific examples are provided within a theoretical framework as it pertains to the roles that are described.

A number of years ago I was asked to write a paper describing which theoretically based behavioural perspective I prefer. Even then it didn’t make a great deal of sense to declare one perspective over the other as I believed this would limit my effectiveness in working with the diverse populations and people I would support in the field. Charles and Charles state that “it is this richness in options that makes the child and youth care approach so powerful” (2003). As it turns out, after spending the last eighteen years working in the field of child and youth care, my feelings about utilizing a variety of approaches have not changed. I continue to utilize as many theoretical foundations in my work as I can fitting the interventions to meet my client’s needs, as opposed to try to fit the client into a single model. This holds true when I am required to work with the families as well. As a school based child and youth care practitioner the job description we are provided tends to over simplify the often complex and involved role we play in working with families. The following case sample will explore these roles in more detail and offer specific examples of how one child and youth care counselor supported a family from the school.

The current support model that schools in British Columbia utilize is closely aligned with Urie Bronfenbrenner’s bio-ecological theory. The emphasis in this theory is placed on the interactive relationship between the child and the four basic systems involved in the development of the child. The first such system is the microsystem which would include the child, family, school and other such influences directly involved with the child. “This is the layer closest to the child and contains the structures with which the child has direct contact” (Paquette & Ryan, 2001). The mesosystem is the next and describes the interrelationship between the structures within the microsystem. Berns (1997) offers “the mesosytem, consists of linkages and interrelationships between two or more of a developing person's microsystems, such as the family and the school, or the family and the peer group”. The third structure is that of the exosystem, which does not directly effect the developing child, however has an immediate influence on the settings within their microsystems. This is effectively described by Berns (1997) as she illustrates “when parents work in settings that demand conformity rather than self-direction, they reflect this orientation in their parenting styles in that they tend to be more controlling than democratic”. The final structure is called the macrosystem, which includes the farthest influences on the developing child such as societal values and laws. This is further explained by Paquette and Ryan (2001) “If it is the belief of the culture that parents should be solely responsible for raising their children, that culture is less likely to provide resources to help parents. This, in turn, affects the structures in which the parents function”.

These systems relate back to the model used within B.C. schools in terms of defining the level of support schools are able to provide a student requiring Child and Youth Care Worker support. For example, levels of support provided in the school are based on the level of need and support the family is willing to acknowledge and accept. A child designated with a moderate behaviour label will receive less service than a child who is categorized as severe. The main difference between the two designations is that in order to receive a severe behaviour label, the family must be receiving community based supports, therefore adding to the child's microsystem, so that a more intensive, coordinated effort can be made between the family and the school. This would point to the importance of not only looking at the student, but at the whole family system in order to further support the change process by the individual, as the bio-ecological model suggests.

Although I tend to advocate for flexibility in this field and adapting to meet the needs of those I support, there are two fundamentals to which I strictly adhere. The first is that my job is to work myself out of a job. The second is that the people I support are the agents for change and I am there as a guide and support. As a Child and Youth Care Practitioner it is important to develop support situations where the family becomes empowered and develops competency in dealing with the issues they face. Keeping this in mind, as a school based CYC practitioner, I am often asked how I work with families, what do I do, and how do I do it? In essence, what is my role in working with a family from a school based perspective? The answer is never simple, or the same. Family dynamics are difficult to assess due to the fact that my interactions with the child and their family occur primarily at the school and family needs are ever changing. This is clearly evident with Darma, a student I began supporting in the school, who turned out to have a severe anxiety disorder which had a profound impact not only from an educational perspective, but on her family as well. As Oswalt (2005) states that “how a child acts or reacts to these people in her microsystem will affect how they treat her in return”, thus acknowledging the possible implications the anxiety could have on the people closest to Darma.

I often marvel at how much I continue to learn on a daily basis. This is especially true in Darma’s case. I make it a common practice to re-introduce myself to our students at the beginning of the school year. I also introduce myself to our new students to welcome them to our school, let them know who I am and offer them my help should they need it. This was the first time I met Darma as she came to our school in her grade five year. At that time, Darma presented as a quiet, unassuming child who would fit right in to the regular routines of the classroom fairly quickly. Not long into the year, however, Darma’s teacher began to notice that she often appeared tired and missed a lot of school, so I initiated a call home to see how things were going.

What I discovered was that Darma was struggling with coming to school on a regular basis and would either claim she wasn’t feeling well or fight with her parents about coming. The most surprising aspect of this struggle was the degree to which the fighting was described to us. When Darma was told by her parents that school was not a choice she would become very aggressive and begin to hit, bite, yell and cry as her parents attempted to get her ready to go. This was a very difficult scene for the school staff to comprehend as Darma was always quiet at school and appeared to have a very calm disposition. I still remember the first time I actually saw the struggle she had with coming to school. As her father brought her into the school that day she was screaming and lashing out at him with her arms and legs in an effort to get away. The girl I saw at that moment was the polar opposite of the one we had as a student. The degree of panic that this child was experiencing at having to come to school was extreme, to say the least, as her fight and flight instincts consumed her.

In this instance, my role was to help the student regain control and support her father in dealing with this emotionally draining situation. Darma and I were able to meet in a quiet space where we worked on some cognitive behaviour strategies such as positive self talk and goal setting to help her regain some control over her fears. A short time later, Darma made a successful transition into her class room. I then called to debrief the situation with her parents and offered assistance to support the family to help their daughter. This event marked the beginning of what was to be a very long road for Darma, her family, and the school.

Schools in British Columbia have developed a “team approach” in working with students who have social, emotional and behavioural difficulties that impede their learning. This is supported by the BC Ministry of Education (2006) which states that “the school based team may access other school or district support services, and or request additional assessment”. This also coincides with Bronfenbrenner’s bio-ecological model by including the number of support services to the child's microsystem. Ideally the team will include the teacher, administrator, counselor, CYC practitioner, the student’s parents and/or an outside agency (ie. doctor, pediatrician, psychiatrist or therapist). In Darma’s case we began as a team of the education professionals listed above along with her parents.

From that point, the first step in working towards change was to assess Darma’s level of functioning at that time and begin to look at what triggers were behind her thinking when it was time to go to school. There was a very delicate balance to be made here as the team attempted to discern whether or not we were dealing with a behavioural issue, a mental health issue or both. We didn’t want to compound the problem by making her come to school, thus ignoring the anxiety, or allow her to stay home which would reward the behaviour. Darma’s parents agreed to seek medical help to see if there were any physiological factors contributing to the struggles she was having.

My role became one of an advocate for Darma and her family when describing to the medical professionals how Darma’s docile nature could turn very quickly. This was no small task and I shared in her parent’s frustration when they described the looks of disbelief they would receive when trying to explain Darma’s behaviour as her panic began to consume her. I became coach and mentor as I encouraged her parents to keep looking for answers and not give up. The support I provided took on a more humanistic approach as I worked to help her parents through this difficult time. As Rogers stated in his interview with Michele Baldwin, simply by being there and using my “self” (Baldwin, 1987) I was able to provide Darma’s parents with a sense that they were not alone in their struggles. Rogers further supports this when he says “I recognize when I am intensely focused on a client, just my presence seems to be healing...” (Baldwin, 1987). I also used strategies described by Loeschen such as “Making Contact, Validating, Facilitating Awareness, Promoting Acceptance” and “Making Changes” (2002). I spoke to Darma’s parents on a regular basis to support and validate the efforts they were making and acknowledge the challenges they faced from day to day. I also spent time reassuring that they were doing their best and worked to engender some hope that the situation, as it was, would get better in time as not all avenues of support had been tried. Loeschen (2002), supports this as she describes Satir would validate “people’s efforts, their pain, their individuality, their feelings, their wants, and their points of view”.

Darma was eventually assessed and diagnosed that Spring with Generalized Anxiety with Panic Disorder, by the Mood Disorder’s Clinic at BC Children's Hospital, prescribed medication and sent home. Darma continued to struggle with her attendance, although the panic attacks became less frequent. She began to hear a common language of cognitive behaviour strategies that were discussed by the team, and was provided with the time to check in with me every morning at school. She had also begun to take a more vested interest in her own progress as she fought to change some of her own thoughts, thus taking more control of her emotions.

I was away for Darma’s 6th grade, however before the grade seven year began I had formulated a plan, within my role on the team, which seemed simple enough. Get the family some external support. From that point on my role became very complex and seemed to change from one minute to the next. I would often begin the day managing a crisis, which was typically dealing with a panicked child, then quickly turn to the role of Counselor as Darma worked through the process of getting her fears under control. I achieved this by reestablishing a connection with her through the use of a strategy described by Loeschen (2002) as “attending”. This simply means that I gave her my undivided attention that allowed her an opportunity to express her concerns and begin the process of support and healing. This would eventually lead to a shift in using cognitive behaviour strategies to help her regain a sense of control by challenging the harmful thinking that was causing her fear. The use of cognitive behaviour strategies became paramount with Darma due to their effectiveness and ease of use. (James, Soler & Weatherall, 2004) state, “Cognitive behavioural therapy was found to improve symptoms of anxiety in 56% of those children and adolescents who received it”.

After such an episode I would then make contact with her parents to allow them the opportunity to debrief which would also provide me with useful information as part of the continuous assessment process. I would then consult with her teacher and the administrator, keeping them informed of any pertinent developments in Darma’s life. As I look back now on all these different roles the most important one seems to have been facilitating and advocating on behalf of her family to get some help outside of school. The concern that was shared by her parents was the prospect of high school and what that would look like for their daughter the following year. It was imperative that some resource was accessed to help Darma, and that her parents and siblings learn some strategies to help cope with the challenges facing their family.

As a team it was decided that the first logical step in the referral process was to take inventory of what had already been covered. At this point in time, we were aware of the anxiety diagnosis and that Darma was taking medication to help alleviate some of the symptoms, yet the general feeling of the team was that more could be done to help. Therefore, a meeting was organized within a few weeks of the school year to gain a better sense of the needs of the family and gain a clearer understanding of what other interventions the family was willing to try. From the meeting a plan was then developed to address the many immediate and long term needs of both Darma and her family. In the short term, a behaviour plan was implemented focusing on Darma’s strengths that allowed some transition time between getting to school and going to class. Assignments were adapted to help minimize the amount of anxiety her academic work load created. School was presented as non-negotiable and attendance was mandatory. However, the day could begin with a check in with me and some possible cognitive behaviour interventions to help alleviate any stress and start the day on a positive note. Darma was also given an automatic pass to come see me if the anxiety was too difficult to manage, although she was encouraged to use this option sparingly. A group was established where I developed activities to work on building self esteem and confidence for our grade seven girls as they all prepared for high school, and Darma was expected to participate. She was presented with an entirely new scenario which included the school and her parents working more closely as a team to ensure her success.

The second short term intervention was to see their family doctor to gain support in moving any referral process along as quickly as possible. These short term strategies helped give the team a sense of direction and seemed to help alleviate some of the concerns her parents had about making progress with their daughter. The next step was to establish a plan to address the long term needs of the family in terms of continuous support when the team could not be counted on for help.

As mentioned earlier, it seems counter productive to have families become solely dependent on the school for any kind of long term support. Schools are limited by their very nature in terms of the type of support families can receive, whether it is due to the hours, holidays or even by what the system is mandated to do. For example, working with families within their own homes, although not unheard of, is not yet a common practice, which makes it difficult to truly assess the nature of a family’s needs. With this in mind, and as part of the long term strategy, Darma’s parents were directed to Child and Youth Mental Health and asked to see a person with whom I had made contact in the process of gathering information on behalf of the family. Through this referral we were hoping to establish a connection between the family and a psychiatrist who could closely monitor Darma and her medication while providing constant feedback to the rest of the team in terms of how to best continue to provide effective support. Throughout this process I was often the person contacted at the school by community based professionals as I had developed a close relationship with the family and had some sense, from an objective point of view, what their needs might be.

The next step in the referral process was to access a new support service that the school district had to offer that provided a multi-disciplinary approach to working with students who were experiencing extreme anxiety. Having heard of this new program from our school’s integration support teacher, the questions became what is it?, how do we access it?, and does it fit with the family needs in this situation? The importance of developing a solid professional network paid off as our questions were answered promptly and our team felt that this was indeed the type of program that was needed. The process of accessing the resource was fairly straight forward and required that I become an advocate on behalf of the family and present the concerns and needs on their behalf. Within two weeks of presenting the case, Darma’s family were informed that they had been accepted into the program. This provided them access to a family therapist, integration teacher support and 1-1 Child and Youth Worker time with people who had specific training in dealing with anxiety disorders. An intake meeting was scheduled and a comprehensive plan was developed by a multi-disciplinary team which addressed the long and short term needs of Darma and her family.

Regular updates and check ins continued to happen in order to continually assess the effectiveness of the plan and changes were made when necessary, yet it wasn’t long before progress was being noted. As grade seven came to a close a discharge meeting was planned and the idea of transitioning into high school along with follow up support through Child and Youth Mental Health were discussed. This meeting marked the closing of my involvement with Darma and her family. However, I do receive regular informal updates from her parents as to how she is doing in high school.

One of the benefits of being a school based CYC practitioner is that I can keep up to date with how students I have supported are doing when they move on to other schools. The main reason for checking in on their future progress is to help maintain some level of the relationship. Charles and Charles (2003) state that “The relationship we develop with our clients is what creates change, not some grand intervention of the day that we all rush off to learn so that we can show the world how brilliant we are”. I recently saw Darma when she came by for a visit and we talked about how her summer went and what high school was like for her. I was pleased to hear that she was doing well and continuing to participate in a “girls group” at high school. She was attending school on a regular basis and felt more capable of managing her negative thoughts about having to go there. The family work was also continuing with steady progress being made. My work as a Child and Youth Worker with this family is illustrative of the changing, complex and systemic role filled by CYCC’s in today’s school system. When I am asked what I do in my role as the school’s Child and Youth Worker it is often difficult to explain in concrete terms. This situation offers concrete insight into the multiple roles a CYC practitioner can play within the school system. Schools can be considered to be the “hub” of activity when working with children and families as we are the one potential support system involved in the vast majority of all children's lives. The simple fact that they have to attend school makes this true. Currently a challenge in supporting families is that we are not equipped to deal directly with the complex issues that can be present. Thus we need to also become an important referral resource.

It is extremely important to work as a team when promoting effective change for children and it only makes sense to expand on the external support systems given the nature of our role in school. Paquette and Ryan (2001) offer that “The bioecological systems theory holds that these bi-directional relationships are the foundation for a child's cognitive and emotional growth”. As a CYC practitioner and member of a team we are accountable to provide valuable insight and recommendations to help support the change process for children and their families. The need to stay informed and engaged with available outside resources and maintaining a solid professional networking system ensure that we are able to provide the most up to date and effective resource interventions. We are also expected to advocate for the best interest of the child and their family and often are relied upon to facilitate the coordination of resource professionals. Effective change is difficult to achieve for families in the absence of a broader support network whether it be other family members, professional community agencies or community based social programs. Oswalt (2005) maintains that “how these groups or organizations interact with the child will have an effect on how the child grows; the more encouraging and nurturing these relationships and places are, the better the child will be able to grow”. While we work towards establishing these connections sometimes the best we can offer the families with whom we work is a level of hope that things will eventually progress and get better. In fact, Loeschen (2002) states that Satir “believed that hopelessness drained people of the energy necessary for change”.

As a father of three children, I too, understand that all families go through difficult times. The need to have a support system to raise my own children and strive towards them being the best they can be is often paramount. The reality is that we all need help sometimes. Bronfenbrenner’s Bioecological Systems Theory addresses the larger aspect of the community coming together to support families and raise children to become healthy members of society. In essence when one family or child flounders, the community as a whole suffers as the underlying impact that family or child has can be much greater than it appears. Thus, from a family systems perspective, it makes sense to involve other aspects of the community to provide the support foundations families sometimes need. As a school based child and youth worker it seems to me that is what “best practice” should be.

References

Baldwin, M. (1987). Interview with Carl Rogers On the Use of the Self in Therapy. The Journal of Psychotherapy & the Family, 3, 1.

Berns, R. M. (1997). Child, Family, School, Community; Socialization and Support (4th ed.). Harcourt Brace.

British Columbia Ministry of Education (2006). Special Education Services: A Manual of Policies, Procedures and Guidelines. Retrieved November 22, 2008, from http:/www.bced.gov.bc.ca/specialed?special_ed_policy_manual.pdf

Charles, C., and Charles, H. (2003). Guidelines in Child and Youth Care Family Work: A Case Story. Child and Youth Services, 25, 1/2, pp.95-115.

James, A., Soler, A. and Weatherall, R. (2004). Treating Anxiety Disorders in Children and Adolescents: Evidence Supports Cognitive Behavioural Therapy as an Alternative to Drugs. Retrieved November 23, 2008, from http://www.knowledge.offordcentre.com/anxiety/ summaries/anx_evidence01.html

Loeschen, S. (2002). The Satir Process: Practical Skills for Therapists. California: Halcyon Press.

Oswalt, A. (2005). Urie Bronfenbrenner and Child Development-Child & Adolescent Development Overview. Retrieved November 26, 2008, from http://www.mentalhelp. net / poc/view_doc.php?type=doc&id=7930&cn=28

Paquette, D. And Ryan, J. (2001). Bronfenbrener’s Ecological Systems Theory. Retrieved November 22, 2008, from http://pt3.nl.edu?paquetteryanwebquest.pdf  

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