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Therapy?

2009

Here goes!!
 
I am a CYW student in my last year at Ryerson.  I graduated from George Brown as a CYW in 1993. During my years of experience this question has come up several times and now recently in my courses.
 
Do we offer therapy and or what?
 
In one course last summer, (taught by a prolific CYW writer in our field) we were told that CYWs do provide therapy and we should see ourselves as therapists. When I challenged this, I was told clearly not to undermine myself or our field.
 
In my present course, (also taught by a prolific writer in our CYW field) our readings are contradicting this idea, but suggests we do things in a therapeutic fashion, and was clear we are not therapists.
 
My thoughts over the years are we do both. Therapy means "to heal" and I believe that we are often in positions were we are either offering support in a therapeutic manner, but at times we set up structured times to discuss specific issues that have healing goals/outcomes. ie: running groups, one-on-one structured time to discuss anger, self-esteem and now more than ever we are working with families and family goals,  (the only difference at times is the work is done in the home), and much more.
 
This appears bigger than a couple of CYW courses having different opinions; it's about our profession and perhaps we should try to find some consistency to be clear for ourselves and for other professions that we work with.
 
Thanks
 
Jenn
...

I believe we are such a young profession that we are still trying to create our own identity!  If we do therapy then my question is what type of therapy do we do?  I graduated in 98 and we have some therapeutic value in our work but the whole idea of us healing the young people. I don't necessarily agree with. I think the youth heal themselves when they decide to and If they decide to after we set some triggers in place for them. It takes them to respond to those triggers which in turn results in their healing process, therefore they heal themselves
 
Manjit Virk
...
 
Hi there,
I think you will as many opinions as there are people with regards to this topic.  I believe that generally speaking, child care workers are not therapists.  Of course, if you want re-define "therapy" you could do so until almost anyone qualifies as a therapist.  The work that child care workers do are of therapeutic value.  Many practitioners from different fields of work do work of therapeutic value, that contributes towards the overall developmental and treatment goals of a child, but not everyone in that team is a therapist.  The therapist is a person trained specifically in the application of various therapeutic methods, and usually has a masters degree or similar level qualification and supervised clinical/counselling training.  It is often a very "narrow" kind of work, although of course it is not true in every case.  I see child care workers as working very "broad" in their intervention, cutting across development and individual child issues, milieu planning and organisation, activity programming, etc.  It may be that some child care workers become sufficiently qualified to work as therapists.  The same holds true for social workers - not all social workers are therapists, but some social workers qualify themselves further and then work as therapists.  Of course, the work of a social worker almost always holds therapeutic value for the client, but that does not quite qualify it as therapy per se.
 
Just my thoughts...
 
Werner van der Westhuizen
Port Elizabeth
...

Jenn asked about whether CYC's do therapy.  I was looking forward to more discussion on this. 
 
It does of course depend on how one defines therapy.  I do not like to consider everything that is beneficial for our children as "therapeutic."  I think this denigrates therapy.  I also think it denigrates our children.  I have seen programs that talk about everything they do as being therapeutic, from their 'state of the art' behavioral therapy program to their recreational therapy and their 'riding therapy.' 
 
Their behavioral therapy wasn't even good behavior management.  I suspected that it did more harm than good for some children. 
 
About the only recreation the children got was when the recreational therapist took some of them on an activity .  I'm sure play and activities were beneficial for the children.  It was often all they got.  I'm not so sure it rose to the level of therapy.  And what's the message to the kids - you're so disturbed you need a therapist in order to play?  (I do know that specific and valid goals can be accomplished through recreational therapy, but most of what I saw was just activities with reasonable adult
supervision.)
 
The riding therapy program allowed certain kids with enough points to clean the stables, feed the horses, and maybe sit on one for a walk around the pen under the supervision of one of the teachers who liked horses.  Beneficial, teaching kids responsibility and caring for a dependent animal, yes. Therapy, I think not. 
 
And so with everything being therapy, I saw very little actual therapy provided for the children. 
 
In medicine, therapy is provided by licensed therapists who are trained to work with patients in a specific modality to achieve specific therapeutic goals that change the patient.  For example, a physical therapist may be assigned to provide therapy to strengthen a specific muscle group to reduce the risk of injury to the knee. 
 
I think the key ingredients are:
1.  use of a specific modality
2.  working with the person
3.  to accomplish specific goals
4.  that result in a fundamental change in the patient.
 
I believe that when CYCs use relationships in their work with children in their life space to help children change the image they have of themselves, to change the way they view their world and consequently to change the way they relate to other people, to change their view of the world from that of a dangerous and hostile place to one with opportunities for them, and to help them learn to take advantage of those opportunities, that this is a fundamental change in the children of a most important therapeutic nature. 
 
When CYCs are successful in accomplishing this with children, I believe it does indeed rise to the level of therapy of the highest and most important order. Even though the CYCs may not be licensed to do so.  And whose fault is it that CYCs are not licensed?  And if CYCs do not do this, who will?
 
Just my thoughts.
 
John Stein
New Orleans
...

I deeply agree with John.
 
I´m an Austrian psychotherapist working with children and youth, but also work in the residential care of children. Few years in my country ago it was very "modern" to make everything "therapeutic". Suddenly all normal residential care programs disappeared and the new therapeutic ones grew likes mushrooms. Now we are correcting this issue and specially in our residential care programs we try to improve the pedagogic work. But it is also a question how the staff of such programs defines themselves. We try to give them more profile and self-esteem as pedagogues. Also it took us a time to realize that "therapy" is not the magic medicine of the 21st century to heal all the failings of our society. Even mentally ill children do not need therapy the whole day long.
 
Otherwise I think pedagogic activities are only one step in a "continuum" of possible activities in professional children and youth care. If you see every interaction with our clients as a step in an continuum of activities, and these steps are depending on what efforts are needed in a specific situation, so you can say everything what we do with our clients is (psycho)therapy.
 
Best regards to all colleagues around the world!
 
Hermann Radler
‑‑‑
 
Thanks for your input John,
 
It appears that even our most prolific writers in the CYW field are at different ends of the spectrum on this.  I would like to hear from them also.
 
Perhaps this would make a good independent study topic.
 
Jenn
... 
 
Hi John Stein, a well put contribution. I recognise the difficulties engendered when we get lazy with language. There exists a tension between the medical and social models in which some people defer to the medical terminology and define therapeutic intervention only in those terms. The more recent upsurge in 'alternative therapies' has an appeal to many people who wish to embrace the language of therapy to validate what may be 'quack' interventions dressed up as something more.
 
A CYC workforce with a clear professional identity could regulate the less than helpful aspects of both models whilst furthering the dialogue regarding the efficacy of the therapeutic relationship. Oops there I go getting lazy with terminology.
 
Peace 
Jeremy Millar
Scotland
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