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120 FEBRUARY 2009
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new series: BOOK CHAPTER*

Child and youth care family support work

Jack Phelan

This article describes the theoretical process and practical skills involved in a Child and Youth Care approach to family work. The behaviors and boundary dynamics for this worker are described as being significantly different than those envisioned in family therapy approaches. Concepts discussed include; gaining credibility by actually living with difficult youth, trusting families to know what they need, supporting families by doing useful things in the life-space, having a systemic view of families, maintaining clear boundaries in an intimate environment, the use of analogue communication versus dialogue, and having an observing ego.

What is it about a Child and Youth Care (CYC) approach to working with families that is so unique? So we should start with a basic description that forms the rest of our discussion. Child and Youth Care family support work is a powerful, distinct, and different method of helping families to function more effectively and to acquire the competency and hopefulness that will enable them to be more successful in the future. Child and Youth Care work with family as the focus will be more clearly understood as we articulate Child and Youth Care work with youth.

Learning in residential care
Residential programs provide the basic training ground for many Child and Youth Care professionals. The Child and Youth Care professional engages the youth by living alongside him/her, building a safe and predictable environment often by “containing” injurious or irresponsible behavior that the youth may display (Winnicott, 1984). The worker engages in nurturing and caring interactions with youth who are especially hard to create attachments with and creates safe, trustworthy relationship connections in order to allow the youth to learn and grow.

CYC professionals reach a crossroads fairly early in their career (usually between year 1 and 2) where they must choose between blaming parents and families and trying to rescue the youth from this influence, or seeing parents and families as partners who may also need our support to be more capable of handling their life challenges (Phelan, 2003). Good family support workers have chosen the latter path.

The experience of living day to day with the behaviors and beliefs of this unique population is a fertile training ground for future success with family work. The most straightforward issue is that the worker develops a tremendous respect for parents through experiencing the difficulty of living with these youth who have very challenging behavior. The more skilled worker understands how to use developmental lenses and other theories to support the youth’s strengths and appreciates the complex reasons for the existing behavior.

Parents know intuitively whether the family support worker can “walk the talk” because of having actually dealt with youth similar to their own. Without at least some personal credibility, the family will have little reason to trust the worker.

A major lesson for the worker is realizing that many people get stuck in destructive patterns of living and want to live more happy lives but do not know how to change. Associated with this lesson is learning that relationship building plays a key role in any attempt to enter a person's life-space, and change will only occur after a relationship exists. The resistance of youth and families to relationship building attempts by well meaning workers also begins to be appreciated and understood as a protective strategy rather than simply as a “negative behavior”.

Another lesson is that most youth are protective of their family, and especially of the parents. Even when youth experience tremendous relief as the difficulties in the family begin to be addressed, they defend their parents” dignity and status. Youth have idealistic views of the parents who they perhaps they wished they had, and we can see the strength and beauty here rather than the need to create a more “realistic” picture.

Another, more complicated understanding emerges as Child and Youth Care workers become more skilled; the worker sees the value in creating small steps toward change that are developmentally helpful, even though they may not look useful to the untrained eye. For example, workers learn to support behaviors that aren’t the ultimate goal, but are necessary transition stages. So, for example, a youth may be encouraged to be selfish or loud and demanding in order to assist them to acquire a sense of personal power and autonomy. Youth may be supported to make mistakes and do things that are outside the usual rules in order to develop a sense of trust and self-control. These strategies can look foolish or wrong when only viewed on a short-term basis, and unskilled workers may be unable to understand these ideas. The skillful Child and Youth Care worker uses a theoretical map to guide interventions and this ability to have a theoretical lens to look at behavior is crucial to good family support work.

Change occurs slowly and in many ways that are not simple and linear, and skillful workers appreciate this fact. We really do have to resist the urge to tell people what to do based on our view of the world, to allow youth and families the opportunity to create the changes.

CYC family support work
The Child and Youth Care approach includes the use of the family’s life space and actual shared lived moments to create helpful interventions. The power of using lived experience and strategic, immediate, purposeful reflection on that experience, enables Child and Youth Care family support workers to facilitate shifts that simply do not occur with more passive and indirect methods. The boundaries for the workers are more intimate and less protected by professional distancing strategies such as would be typical in an office-based interview. Boundary definition is a key piece of our work, yet we must see our relationship with the family as equal, not superior. The context must honor the parent as the expert on their family and the worker is not only not above the family in knowing what needs to be done, but is even in a “one down” position. One father who had been resistant to many attempts at family therapy, described finally being willing to work with a Child and Youth Care worker who “didn’t come into his home with a plan already formulated about what he needed to do” (Sullivan, 1995).

The work is less reliant on dialogue and therapeutic reflection and more on experiential, lived moments, often co-experienced by the family and the worker. The Child and Youth Care approach has been characterized as the process of arranging experiences that challenge the family to revisit old, self-defeating patterns and beliefs through the cognitive dissonance that arises as a felt experience of success and competence gets highlighted through purposeful reflection in the moment (Phelan, 1999). Workers support youth and families to feel the experience of being competent by actually doing things that are useful and capturing the moment before it evaporates.

The relationship developed between the family and worker is founded on a sense of safety that grows out of mutuality and a “non-expert” stance by the worker rather than the power relationship that occurs when a person goes to an expert to be healed. The process of Child and Youth Care family support work is described by Romanko-Woods (1999) quite elegantly as a three stage model:

I will elaborate on these details as we proceed.

Systemic approach
The first and most basic knowledge needed for a student or new worker is to acquire a systemic point of view. The theory of family systems is well described in many books and articles that are readily available. A competent family support worker uses tools like genograms (McGoldrick, 1985) and eco-maps (Holman, 1983) to assist family members to understand the systemic influences in their lives. Understanding the complexity of the family as a system that protects its own integrity is a vital building block.

As a supplement to this, it is useful to use practical stories as a way to embed the concepts for new practitioners.

–During the day I worked with a group of 12 children, two of these were brothers, Benny and Kenny. Benny was older by a year at 9, but Kenny often seemed older, since he was more articulate and outgoing.
Part of the program was recreation, lots of trips by subway to all parts of New York City, but the mornings were spent on reading and English skills. We used games and activities; Hangman, 20 questions, and a series of high interest books of increasing difficulty in a reading program set.
Kenny was a good reader, but Benny couldn’t read at all. Both boys enjoyed being with me and we often spent extra time on reading. Benny tried very hard and even memorized a few of the easier books to impress me, but he wasn’t able to read.
After several weeks, and because I had met their mother who was a classroom aide in the school system, I asked the boys to see if their parents would allow me to visit them at home to talk. I didn’t have an elaborate plan, I was just looking for support.
When I visited them in their apartment in “the projects”, I was struck with how much Benny looked like his father, while Kenny resembled his mom. The dad was a bit shy and reluctant to talk, but his wife got him to join us. He was a cab driver, who had worked hard even as a young boy in Puerto Rico and had left school very early to make a living. He stated that he had never learned to read, and was obviously proud of his wife, who had completed high school. He was also proud of himself and what he had accomplished through his own hard work.
I asked him if he thought it was important for Benny to be able to read. He said that he didn’t know if it was essential, since he had succeeded without this skill. His wife jumped in and said that she really wanted Benny to read, and her husband said, “OK with me, if that’s what you want.”
Somehow I realized that this wasn’t enough, so I asked the father to decide for himself if he wanted Benny to read. He said he wasn’t sure, and I asked him to take a few minutes to decide. He spent a few minutes thinking and then said “This isn’t Puerto Rico, he will need to read in New York.” I asked the parents to call the boys in to join us and the father said to Benny that he wanted him to learn how to read. We talked for a few more minutes and then I left.
Benny was reading within a week.” (Phelan,2001).

When working with a particular youth on a specific behavior, we can often get lost inside the immediate dynamics and ignore the much more powerful and pervasive influences that are really within our sphere of ability to utilize to create change. I am often saddened by the individually focussed efforts of some workers that totally ignore both the family and the other systems that surround all of us.

Micro, meso and macrosystems
Another useful framework is Uri Bronfenbrenner’s (1979) work (and interpreted by others such as Garbarino, 1982) on ecosystems: family, peers, school, work, religion and culture in our microsystem; neighborhood, career opportunities, local political environment, etc. in our mesosystem; and economic conditions, national issues, and environmental concerns in our macrosystems. Each of us lives inside a system of close and distant relationships that influence who we are and how we behave. The worker can use Bronfenbrenner’s work to support the person and family to maximize the beneficial relationships available to them and to increase the family member’s effectiveness, happiness, and hope by coaching them to understand the mutual influence process that occurs. Many families who experience difficulty do not negotiate effectively within their own micro- and meso- systems, because the members have a limited, egocentric view of their connections with others. Workers can also appreciate the paradox of being inside the life space of a family at the same time they are outside of it in the role of coach. In summary, ecological theory gives the worker another lens to view the operation of the family in their world.

Most importantly, systemic thinking will assist the worker to resist the urge to blame the parents for past and current issues, especially because many people will be encouraging the worker to do this. As we help family members to see multi-generational dynamics and their influence on the present, everyone can have the opportunity to minimize blame and start to work together. Child and Youth Care work is typically focussed on individual youth, and systemic thinking will challenge this limited view.

Systemic thinking as a way to view families is shared, hopefully, by all professionals who work with families, and it creates connections and opportunities for essential dialogue across disciplines.

Life-space
The primary difference from family therapy and basic foundation in Child and Youth Care family support work is that it is life-space work (Redl and Wineman,1952). It happens during the daily, real events of living in the moment. The worker performs his job in the much more dynamic and less structured environment created by the family in their home rather than in an office or agency space. The real work is less talking with and more doing with. The family often requires very real help in the form of physical needs and practical assistance and less cognitive reflection or verbal strategy advising. The helping occurs through lived-experience work, not reflection on prior or future behavior. Generally, families resist reflecting on past, painful issues and Child and Youth Care workers see this as not particularly useful in any case, since distortion, self-protection and learned helplessness often are the end product.

A story may illustrate this more effectively. This example was given at a workshop delivered by the Batshaw Youth Services (Montreal) Child and Youth Care Family Support Program staff at the Inter-Association Child Care Conference (Maciocia, 2001).

Early one morning , a family support worker gets a call from a mother of a family on his caseload who is distressed at her teenage son's refusal to go to school, an ongoing problem. The worker visits immediately and is confronted by the son who states that there are no clean clothes to wear and he isn’t going to school in dirty clothes. The parents describe that their washing machine is broken and there is no money to fix it. The worker spends some time listening and then takes a look at the washing machine. He sees what needs to be done to fix it and returns that afternoon with tools and the necessary part. As he lies on the floor on his back fixing the machine, the boy and both parents hover around watching. He spends the time fixing the washer as well as creating a discussion between the family members about the things that need to happen differently in the home. Two hours of fruitful discussion later, all is done.

This type of intervention would not be envisioned by most other professionals, yet it does describe an effective Child and Youth Care approach.

Typical counseling strategies are a form of dialogue work, while we are using “analogue work”: a use of experience to create sensory data in the moment that can be channeled into energy to change. Reflection and observation are then purposefully inserted into the life-space event as a framework to challenge people to shift patterns and beliefs. (Phelan,2001). The ability to exist alongside our families and to co-experience the life situations as they occur enable Child and Youth Care family support workers to understand the often complex rationales that keep families stuck and helpless.

One of my students described her work with a family that had seemingly resisted all attempts to change.

The family consisted of a mother and three small children, and the referral described a house that was dirty and chaotic. The goal for this worker, which had stymied other workers, was to get the mother to keep her home more clean and organized so that the children would have a safe environment. The worker spent several visits creating a safe relationship with the mother and trying to live alongside her as she lived her life. The obvious task of cleaning the house could have been done in a few hours and the mother would often do this with other workers present and assisting her, but couldn’t do it on her own. This worker resisted suggesting this or commenting on the chaos, waiting for the mother to lead the way. As they were discussing things on the third or fourth visit, the mother finally stated that she really wanted to be able to “clean up this mess”. The worker asked her when her life hadn’t been such a mess and the mother smiled and said that once as a young teen she had won a sports trophy. They found the trophy at the back of a closet and the mother looked at it proudly. The worker suggested to the mom that this was a real part of herself that she often forgot about and that perhaps she would want to put it somewhere in sight to remind her of her capabilities. Next visit the mother showed the worker that she had put the trophy on a small table in the hallway and the worker noticed that this table was perhaps the only clean space in the home. As they continued to meet, the mother described that when she was feeling overwhelmed, she would look at the trophy and feel better. Over the next months, the house became significantly cleaner and organized and the mother described that she no longer needed help. (Lee, 1998)

Boundaries
Working in the life-space often produces anxiety, since personal safety can be a major concern. This lack of safety is also felt by the family members, and boundary setting can be an important issue for all. It is important for the worker to feel and be safe before trying to assist the family. Family support work might even be described as working without a safety net under you. The temptation is to shield yourself by assuming an expert stance and create distance between you and them.

The boundaries are much more intimate than in other helping roles and the worker is exposed in a way that people behind a one-way mirror never experience. There is no room in this work for a passive observer role, and families will challenge workers to be present by creating chaos and danger in the moment. Barking dogs, unwanted guests, angry spouses and youth, and loud TV sets are all part of the process. The worker needs to model positive ways to deal with the chaos and lack of connection that is often present as family members struggle with the fear of abandonment if they change too much. The worker also starts to share the experience of “standing on the edge of the pit of emptiness” (Kaplan, 1989) and can increase their own empathy for the family.

Another major boundary issue is the worker who is too intrusive and too controlling. There is a tendency to want to give advice, a practice that does not work; to focus on the problems and difficulties, which does not work; to assume that the parents do not know how to run their family, which is not true; and to think that the family sees your interventions as helpful, which is wishful thinking. The most successful Child and Youth Care family support workers are described by families two years later as “nice people who did very little, we did it all” (Sullivan, 1995 p.43).

Role of helper
CYC family support workers describe a “one-down” or non-expert role as most useful in supporting families to make changes. In this living alongside role where you are co-experiencing events, how does one manage to be deliberately and strategically helpful and still be genuinely present? Where does expertise get in the way, and when does being too friendly become a deficit? What exactly is appropriate professional demeanor in this situation?

As I enter your life-space and join you, in some ways it becomes my life space also. If I fully accept my presence in this moment, will I lose my ability to become deliberately supportive for you? Can I be present in your life-space without making it my life-space too? It’s not possible to be totally neutral and unaffected (nor is it desirable) but it would be a mistake to lose focus on supporting the family as the main task. Yet if I hope to support you to live your life better, with less pain and more hope, then the place to support you is in your actual life-space. This “living with” becomes a mutual influence process, and it is important for the worker to remain both safe and helpful without being absorbed into the family’s system. Supervision and peer support are essential in this work and the Child and Youth Care worker needs to have a clear theory and strategy map to stay out of trouble.

CYC family support work training includes helping the worker to develop an “observing ego” which facilitates maintaining an objective view of the inter-personal dynamics that are occurring. The ability to be a reflective practitioner (Schon, 1983) is an essential skill. The worker must accept and understand his own response and be able to do the same with the family’s response. It is difficult to keep issues separate at times.

To use the ecosystem approach mentioned earlier, the worker can position him- or her- self to be a coach to the family, supporting them to maximize the beneficial relationships available to them while not becoming another part of the micro- or meso- system of the family. The role of helper is most strategically positioned in a way that the worker can see the family’s whole ecosystem from outside and then step into it at strategic points in the life-space to be supportive. Thinking systemically enables the worker to utilize the interaction between people for maximum benefit.

CYC family support workers describe the need to nurture parents in the early stages of relationship building. Many parents have not had the experience of being nurtured as children and can behave very childishly at first. The worker can accept this need and gradually bring the parent through developmental stages to the point of being a nurturer to their family. The ultimate goal is to equalize the relationship between parent and worker and support the parent to take over. Child and Youth Care work is founded on creating a caring process, and much of the preparation for the work focuses on nurturing skills, but it would be important to distinguish between the adult–child nurturing role and the adult–adult relationship that needs to eventually exist.

Summary
There are some essential building blocks in the process of becoming a competent Child and Youth Care family support worker.

The skilled practitioner has integrated a systemic point of view into all their assessments and observations, with all the tools available to most family work professionals. In addition, the use of the life-space and the process of co-experiencing the lived moment as fellow travelers without losing one’s focus as a helper is a core skill. The ability to balance intimate boundary issues and to maintain an objective, reflective analysis of dynamics that occur as one “works without a net” requires experience and maturity.

The empathy and relational connection developed as one works with challenging families creates the ability to understand the logic of crisis dynamics that keep these family members connected through the centrifugal force of whirling around together. Skilled workers can live alongside this energy without being caught up in it and support the family to connect more safely.

One group of Child and Youth Care family support workers describe how they know when programs which they occasionally visit are using a Child and Youth Care model. If the hairdos, manicures and clothing of the other staff are too formal, they probably aren’t using this model.

So a list of skills would include:

Again, the ultimate goal, as confirmed in at least one research study of successful Child and Youth Care family support work (Sullivan,1995), is to have the family believe that they did it themselves (Sullivan, 1995).

References

Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.

Garbarino, J. (1982). Children and families in the social environment. New York: Norton.

Holman,A. (1983). Family assessment: tools for understanding and intervention. New York: Sage.

Kagan,R. & Schlosberg,S. (1989). Families in perpetual crisis. (p.9). New York: Norton.

Kagan,R. (1995). Turmoil to turning points. New York: Norton.

Lee, D. (1998). Field placement journal entry. Grant MacEwan College, Edmonton, Alberta, Canada.

Maciocia, A. (2001). Workshop presentation on Child and Youth Care family support work. Inter-Association Child Care Conference, Valley Forge, PA.

McGoldrick,M (1985). Genograms in family assessment. New York: Norton.

Phelan, J. (2003). The relationship boundaries that control programming. In press.

Phelan, J. (2001,September). My introduction to family systems theory. CYC-Online , Issue 32.

Phelan, J. (2001). Experiential counseling and the Child and Youth Care practitioner. Journal of Child and Youth Care Work, 15-16. pp. 256-263.

Phelan, J. (1999). Experiments with experience. Journal of Child and Youth Care Work, 14.

Redl, F. and Wineman, D. (1952). Controls from within techniques for the treatment of the aggressive child. New York: The Free Press.

Romanko-Woods, M. (1999). Classroom lecture notes. Grant MacEwan College, Edmonton, Alberta, Canada.

Schon,D. (1983). The reflective practitioner: how professionals think in action. New York: Basic Books.
Sullivan, J. (1995). Unpublished doctoral dissertation. University of Virginia,USA.

Winnicott, D.W. (1984). The child, the family and the outside world. London: Penguin.

* This article was originally published as a chapter in Garfat, T. (Ed.) (2003). A Child and Youth Care approach to working with families. New York: Haworth Press. It is the first in a new series of book chapters which the authors have permission to publish separately and which they have contributed to CYC-Online. Read more about this program.

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________________

Jack Phelan is a Child and Youth Care practitioner who is teaching at Grant MacEwan College in Edmonton. Jack travels to Child and Youth Care schools and programs around the world whenever he can, and loves to be invited to visit new places. He has been in the USA, England, Scotland, Ireland, Holland, Sweden, Denmark and South Africa.

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