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Institutional cultural change?

2015

I work for a large non profit youth serving organization in Minneapolis MN that provides residential and shelter care for children and youth who have been removed from their parents homes or to address behavioral health concerns. The facility is very behavioral, seeing all of kids behaviors as manipulative and maladaptive. For instance a child who wants someone to peel an orange for her at night after she went to bed is met with incredulity. "You can peel it yourself." Another youth doesn't want to wear shoes gets harped on for it. Another youth doesn’t want to go to bed and she is remanded to a Time Out Room. Staff place kids in "therapeutic holds" daily and the burn-out cycle is high with staff being assaulted and more.
 
Little learning takes place and most interventions are containment oriented. Kids cannot co-regulate kids or help one-another, especially if it involves kids going in each other's rooms even if they are supervised. It’s crazy.
 
I am happy to read kids bedtime stories and peel them as many oranges as they want to eat, but then I am seen as soft and easily manipulated and staff don't trust me. I try to be hard but then kids become more automaton like.
 
I’d like to introduce Life Space Crisis Intervention into the program or foster a willingness to see youth as beings in the world who are self determining and worth dignity and respect in their own right. Too often they are seen as kids who need to follow adults expectations to get better. It’s very old school.
 
I am a trained therapist working as a youth worker, or youth counselor as my role is called. I wish to bring the vast history and valid practice of youth caring work that CYC promotes and am a quite flabbergasted that it isn't more a part of the culture. Many of the staff come from corrections backgrounds and I often hear staff talk about how "that kid just needs to be put in a hold."
 
Have folks been part of institutional cultural change? Or even cultural change on one cottage? How did they build rapport enough to gain the relational power to make changes? I think in my case it is a matter of waiting and developing a name for myself as a reliable and capable counselor. I struggle with fitting in however (as always).
 
What have others done in such situations?
 
I find it ironic that the University of Minnesota Twin Cities has a Youthwork program but there are no youth workers in this agency. I'd love to be part of training youth workers to work more therapeutically as opposed to leadership development oriented solely.
 
Thanks,
 
Peter DeLong
...

Hi Peter,

I am a residential child care practitioner from Scotland. Firstly, I would like to say well done for being brave enough to share your experience, I imagine it will be frowned upon by those who are engrained in poor practice for whatever reason. It takes for someone to stand up - with knowledge, skills and experience - to highlight problems and unacceptable standards of care. It is concerning that the young people you look after are being subjected to this though and I would urge you not to stand back and wait. This is children's lives we are dealing with and alongside the likelihood of causing further trauma, the opportunity to help them is bring missed.

I once worked in a children's home where the standards of care gave me real cause for concern, staff morale was low and nobody wanted to be there. The physical environment was run down, lacked space and the local area was almost full with boarded up empty houses waiting to be demolished. The children were uncontained, uncared for and although there was not the same level of restraints that you describe there was a high level of assaults on staff and between the residents. It was a horrible place to work, never mind live. The management team provided little support, pretending everything was ok actually felt worse. I understood the problems couldn't be fixed easily but for me the most frustrating thing was the lack of recognition that problems actually existed. Thankfully I left this placement and shortly after it was closed down until a new purpose build home could be opened. The staff team were listened to and supported to develop training where this was clearly necessary but separating teams of workers who had worked together for years was the most effective way to take people out their comfort zone and break the bad habits that were causing problems. Change is difficult but necessary and continuous learning is essential. Of course it is useful to try and make staff feel valued, cared for and supported during this process because the more they feel like that the more likely they are to treat young people in this same way. Recognizing the strengths of the staff can be a great way of giving people recognition and praise to make them feel change is a positive way forward. It's a difficult task and it won't be easy but bring brave enough to speak out is the first step to learning from the past and service users participation- asking their views and giving them a voice is also a great way to evidence how effective the service is and what needs to change.

Good luck
Tracey Jarvis
----

Dear Tracey and Peter,

Always question. I look back on some of the ‘therapeutic practice’ I have seen over the years and just shudder. Find the right place and time to question. Make sure you have a possible option/solution. Always be positive, and always remind everyone around you that it is in the child/children’s best interest.

“I did then what I knew how to do. Now that I know better, I do better.”
Maya Angelou

...

Thorsborne, Margaret & Blood, Peta (2005). The Challenge of Culture Change: Embedding Restorative Practice in Schools. Paper presented at "Building a Global Alliance for Restorative Practices and Family Empowerment, Part 3", co-hosted by the International Institute for Restorative Practices (IIRP) and Real Justice Australia, March 3-5, in Penrith, New South Wales, Australia. Downloaded 14 April 2005.

This is a good article that outlines the process of culture change. While applied to Restorative Practices ( very relevant to youth work) the framework applies to any form of culture change. I have spent the majority of my career working on change related projects both big and small. There are a few things that stand out for me: Get one other person.....so it is not just you. Engage in a joint "pilot" project that is a form of action research so that everyone can participate and build it as opportunity for no less than success all the time. Use research data.....both narrative/qualitative and numerical/ quantitative so you can speak to the head and the heart. Profile other examples where other methods work. Bring in speakers so you are not the only one singing the song. Respect the fear behind controlling types of interventions. Appreciate the anxiety that change evokes and respond to the emotions while offering practical " what to do". Get clients to speak to what they want and need....do a focus group. Look for stress points for staff...this might be the crisis that can turn into opportunity. Role model and be the change you want to see. Good luck.

Rick Kelly
...

Hi Peter and Tracey,

Thank you for sharing your stories. You both bring to light challenges that have occurred in residential care (schools, agencies as well). Having previously worked in residence and visiting children in residence as a mentor, I too have witnessed such interactions and have too been acknowledged as the soft one, children are trying to manipulate. Making oneself available to the day to day moments such as peeling an orange, listening, reading bed time stories and being responsive to children and youth needs are the foundations on which this profession is built. I had often wondered where and how this gets lost at times in the work. A few things come to mind: Burnout, some staff remain in the same position for years and while I commend their devotion to the position, I have wondered if this could at times be more detrimental than positive. Is it possible for workers to become jaded and hardened by the work after working in the same position year after year? Notably if management and the team are not as supportive as could be. As generations of children and youth change, so must our approach and lens from which we understand their behaviours. Who monitors this to ensure that staff are receiving the current training and skill set that may help in their work? On that note, how much trauma informed training has been offered to staff in residential care and foster care workers? There is a plethora of literature available that validates this Trauma informed care approach for working with children and youth, moreover behavioural approaches. So then I ask again, why is this not included in the training of staff or upgrades?

The need for a regulated body for our profession is so imperative. I hear this is in the works, so I remain hopeful. In the mean time I encourage you to stay strong to your ethics and values as a CYW. I say this time and time again to the college students I teach in CYW, our work is the most humbling experience. To have this opportunity to journey alongside children and youth and families who have allowed us to do so is such a privilege.

So proud to be a CYC!!!

Donicka Budd
...

Hi Peter,

I'm not qualified to offer advice about how to induce change, especially where you work. I'll just offer my sympathies. And I'm rooting for you to succeed in a place I once fled.

I'm guessing about which program you're talking about, but the number of choices is limited. I was probably in that program more than once when I was in graduate school, more than 20 years ago. A research project had been proposed, and I spent some time on a shift, with plans to do it frequently. I didn't make it through the first shift; it made me ill in every way possible. Someone I was working with at the time described what was happening there as 20 years of experience being, instead, one year of experience repeated 20 times.

The big cheese there was traveling around the world offering advice to other programs.

That program and many programs like it have achieved a long-term equilibrium that sustains bad practice over decades. It's an exemplar of stability. The sociologist Howard Becker wrote about a research method he called the "machine trick," which is to imagine the object of study as a machine and then to study what makes it possible for that machine to continue operating. In the case of this program, the forces are entrenched and powerful.

The invisibility of practice is one of those forces. There are lots of ways, both simple and sophisticated, to make practice visible to the public and other professionals, and some day it will be customary for everyday practice to be more visible, at least for programs that receive public funding.

Best wishes,

Doug Magnuson
...

Peter,

I am very much of the view that culture is a central factor in shaping behaviour. Have a look at the paper I wrote for Good Enough Caring last summer to see my thoughts in relation to some of the things you describe. I hope it helps.

http://www.goodenoughcaring.com/the-journal/what-is-better-than-training/

Ni Holmes
Scotland
...

Hi Peter,

I feel with you and respect your strength to stay in the game and promote change in the organization. Here are two references I might suggest based on some of my own experiences related to organizational change. If you don't have the editions, just drop me a note and I'll gladly send you a pdf of both.

Freeman, J. (2011). From coercion to connection: Shifting an organizational culture. Relational Child &Youth Care Practice, 24(1/2), 128-132.

Freeman, J. (2015). Respect, love, and system change. Child & Youth Care Online, 194, 26-30.

James Freeman
California USA
...

Thank you all for your supportive and kind words. There is much to digest. I feel as if I am standing by an window.

Peter De Long
...

Hi Peter,

I’m retired as the CEO of an agency in KY and OH. I must say, you sound like the kind of Child & Youth Care Worker we wanted to hire! Sorry your perspective is not appreciated.

I suppose one thing I suggested to help change attitudes was to ask, “If your brother or sister needed Residential Treatment, what kind of place would that be?” In my experience, I found many Execs who would never consider their own program as a placement option if their own child needed care. Especially in the US, we have largely designed programs that are “good enough” for the children of the poor only. We have forgotten that ALL children deserve our very best. The best staff, the most individualized care, the best facilities, the best food, etc.

I would suggest that in looking for a new position, you use this as a criteria for your search.

All the best.

Charlie Baker
...

Hi Peter,

I like Charlie’s question, knowing the answer would be they would want them to have the best care possible absent of abuse, neglect, intolerance, bursting with respect, nurturance and adults who will listen and respond effectively to a child’s needs and provide safety, belonging achievement, power, and purpose in their lives.

I too work for a large non-profit organization which when I first arrived in 1997 as a Director was very behaviorally based. We began the transition to strength/needs based with the introduction of LSCI about 12 years ago,

Even though all staff here have extensive training in trauma informed care, the cultural tail of controlling behavior without looking for root causes is still the default with many staff. We are much further down the road than 10-12 years ago but are still fighting an uphill battle against cultural norms. Perhaps you’ll be the seed for change in your organization, but until the hiring authority actively seeks people with the hearts to understand, empathize, listen to and encourage children and youth there will only be a few lonely voices crying in the wilderness at your facility. It’s amazing to me that organizations still take a controlling, uninformed care approach when there is a tremendous amount of knowledge as well as models for strength based informed care approaches such as NMT, TBRI and LSCI.

It’s hard to watch adults interact with youth via coercion and threats when we know there’s a more effective, respectful approach. People look for information that validates their personal beliefs – you may have 10 great interactions with kids, but the one that doesn’t have the best outcome will be the one staff with the mindset that ‘your coddling the kids’ will be the one they use to validate their private logic.

I do hope you find others with a human care mindset at your facility or some at least willing to look at things differently.

Best of luck,

Jim Taylor
...

I absolutely think a culture change is needed in the field. I even recall some professors at my school talking about it, because they noticed a lack of leadership in the field. I think part of the problem is people see child and youth care as a job, and not something more. I think mental health is a problem with society, and is not strictly confined to a particular profession. I notice when I go to therapy, or someone I care about goes to therapy, what we find is we do feel cared for within the session, but once we go out into the world we do not feel the same sense of love and connectedness. Therefore, we need to recognize that mental health work is a full time job, not limited to the insitutions we work in. We, as a society, need to look after each other and treat all children as though they are our own children.

Braden Freeman
________

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