Listen to thisA long-established agency for troubled children was following a philosophy based on behavioral control and treatment of pathology. As staff examined their beliefs about the process of change, the climate evolved from enforcing behavior control to empowering youth to develop positive strengths. A charter school was created and new behavior management systems enabled students to shift from an external to an internal locus of control. Students became responsible for achieving therapeutic tasks related to strength-based principles of belonging, mastery, independence, and generosity. Staff training focused on responding strategically to student behavior rather than reacting out of anger, fear, or power.
This article describes a pathway of change from a deficit-based to a strength-based model with troubled youth. The motivation to change was sparked by the question: “Why are we working harder doing what does not work?” What did not work was a combination of obedience training and pathology (medical) models. Our census was dropping. Our staff was frustrated. Something was not right.
Methodist Children's Home is a multi-service agency that serves 220 boys and girls on the Waco, Texas, Boys Ranch. Another 180 children are served in foster care and many other families through the Partnership In Parenting program. Ten years ago, our organization was on a collision course between whom we served and how we served them. We were quick to spot dysfunctional behavior and dynamics, but the program was short on acknowledging and encouraging students to utilize their strengths. Caring adults made all the decisions for our students but not with our students.
At the time we maintained a residential treatment center on the edge of our campus that also housed an outpatient department and medical director. This was once a treatment program of some distinction, built in 1971 as part of the comprehensive community mental health movement. But as Thomas Friedman (2005) points out in The World is Flat, organizations must look forward, regardless of their storied histories. Friedman quotes Michael Hammer:
One thing that tells me a company is in trouble is when they tell me how good they were in the past. When memories exceed dreams, the end is near. The hallmark of a truly successful organization is the willingness to abandon what made it successful and start fresh. (p. 451)
We needed new dreams and began an intentional move toward a strength-based program. The primary focus was to form an alliance with the students and encourage empowering activities that would lead them to take responsibility for their lives. This was a long and painful process. Our goal was to have a positive peer culture in a child-centered community. The program culture has transitioned using the strength-based tenets of empowerment and based on the Circle of Courage (Brendtro, Brokenleg and Van Bockern, 1990, 2002). This childcare philosophy has allowed us to create the program to meet the resident’s strengths. The former residential treatment center and outpatient program was replaced with a charter school associated with the University of Texas. This year we served the most days of care in twenty-one years on the Waco campus.
As we better understood strength-based programming, we became uncomfortable with our discipline system that relied on a level system using point sheets. We questioned how earning points translated into internalizing values. In the fall of 2004, we began to review the level system as literature asserted that point systems were not strength-based. Karen VanderVen recommends “replacing groupwide point tallying with individual goal planning in an alliance between youth and adults” (in Brendtro and Shahbazian, 2004, p. 64). Since working with youth is our goal, we proceeded to explore a revision of our entire discipline system. A task force was formed that consisted of direct care, social services, and administrative staff who were asked to review literature and gather information. Youth involvement was sought informally at first, and more formally as a plan emerged.
Organizational change
Organizations tend to resist change. Hatter and Van Bockern (2005)
discuss needing a guiding coalition for transformational agency change,
as well as emotional investment. So while the task force membership was
open to all interested staff, additional effort was made to ensure
representation from a full range of staff. We listened to as many voices
as possible “especially those areas most directly impacted, including
child care staff and youth. These early efforts benefited the long-term
buy-in and ultimate acceptance of task-force recommendations.
Our administrative mandate was to review relevant literature, gather information and opinions on the efficacy of our existing program, make recommendations, and initiate changes by the year’s end. It seemed fairly simple until we realized that our discussions were moving toward proposing a completely new intervention model rather than adjusting the existing one. Our literature review, however, posed the biggest challenge as it highlighted the drawbacks of treatment models that emphasized tokenism and earning points (Melvin, Korthase and Marquoit, 2005) and focused on coercion and compliance rather than relationship (Smith, 2004). We learned from the literature and from the struggles of others. We noted the importance of individualizing interventions and tying treatment plan goals to a youth’s feedback (Pike, Millspaugh and DeSalvatore, 2005). We also started examining our own values and beliefs about the change process for youth and comparing them with what we were actually doing.
The control issue
One important area that we spent a considerable amount of time debating
was the issue of control; it appeared as an undercurrent to our every
discussion. We wanted the youth in our care to change, but we wanted
them to do it our way! In fact we had carefully outlined every single
behavior that we expected and assigned a point value to it, with
carefully designed level-drops for failure. Allowing youth too much
freedom and discretion in their choices meant we would not know what
they might do; we could not control them.
Miller and Rollnick (2002) also speak of the impact of this control issue in their book Motivational Interviewing: Preparing People for Change (2nd Ed.). They describe our human tendency to resist and oppose anything, or anyone, which appears to limit our freedom of choice or behavior in any way. There is nothing so distasteful as what we feel forced to do, and nothing so appealing as the choice that has been denied us. The harder we push youth in a residential facility to behave in a certain way, the more powerless they feel and more likely they are to resist. Furthermore, they are less likely to internalize any behavior changes that do occur. Instead, Miller and Rollnick insist the arguments for changing behavior must be made internally by youth and by staff engaging in relationships that encourage youth to see the discrepancy between their goals and their behavior.
Positive discipline
So how do we implement this internal locus of control for residential
youth? The simple answer is to let go of external control, but many
fears of chaos and anarchy often accompany this step. We had to balance
safety with freedom “and we had to decide what our underlying
philosophy about people and change was. We also wanted to draw from the
Circle of Courage concept, continuing to be a “strength-based” program,
as well as de-emphasizing punishment. We agreed that change for youth
occurs primarily through caring relationships, though we each had
differing ideas about how to carry this out. Rather than reinvent the
wheel, we decided that we needed a published and research-supported,
developmentally-based guide for building positive and therapeutic
relationships with teenagers. We needed to unite diverse staff around
ways of interacting with youth that fit with our beliefs about kids and
relationships, and we needed to do so in a way which was easily
teachable. We eventually chose the book, Positive Discipline for
Teenagers (Nelsen and Lott, 2000) from the Positive Discipline
child-rearing series. This series focuses on using the relationship with
youth to explore and understand choices, consequences, and actions, but
the youth make the final decisions and live with the results. This
philosophy focuses on natural and logical consequences over punishments.
We found that it encapsulated the Circle of Courage child-rearing
values, was focused on building bridges between youth and adults, and
built strengths in youth. It sought to empower rather than control
youth; it was enlisting rather than insisting (Tate and Copas, 2003).
This approach offered us a way to unite our staff around a
relationally-based intervention system. It gave us a solid foundation
from which to invite our staff to let go of control.
No more point sheets
After debating views on control, power, freedom, and responsibility, we
no longer believed that our existing system was entirely consistent with
the way we thought children and youth should be raised. While we
controlled behavior at times, we were not preparing them adequately for
lives as responsible adults. Bullard (2004) notes how point and level
systems may decrease a youth’s internal sense of control. Smith (2004)
suggested that controlling practices are popular because: 1) they are
quick and easy, 2) they seem to work “at least in the short term, and
3) they satisfy a primitive desire for justice so that we feel more
powerful. Smith advocates for making connections with youth, involving
them in problem-solving, and compromising with them. The task force
clearly preferred this more relational approach that effected a longer
lasting solution, and for the right reasons. Some of our youth had found
ways to “make their points” without addressing their treatment goals,
and some staff found ways to threaten youth with “zeros” in an effort to “control” them. Points had become more important than the behavior. We
therefore recommended eliminating all points and point-sheets.
Youth feedback through relationship
Doing away with points and point-sheets demanded an alternative way of
providing youth feedback. We believed strongly that this feedback should
be through an empathic and caring relationship with an adult staff using
Positive Discipline. This feedback should be regular and should
consistently offer a two-way discussion that empowers youth to take
responsibility for their change process. Above all, we wanted to
emphasize the importance of a youth-centered relationship as the heart
of the feedback process, avoiding control and using the kind and firm
parenting style described in the Positive Discipline series. Providing
feedback in this manner with a highly relational focus takes
considerably more patience, time, and effort. We believed the pay-off
would be internalized change and a maturing of our youth!
Point sheets were no longer necessary but what about a level system? In the end, removing levels may be preferable, but we were not ready to take that plunge. Levels still offered some structure to our program. Therefore, we developed a new level system without language mentioning points, and one that required working on therapeutic tasks (not simply “good” behavior) for progression.
The Spirit of Life
Part of our inspiration came from Centerstone Residential Services, a
youth placement in Nashville that went through a similar journey of
self-evaluation and program change, and who shared their ideas with us.
Similar to their system, our Spirit of Life Program places the control
of treatment in the residents” hands, taking the responsibility for
success away from staff. Working through the Spirit of Life Program,
residents will not “move” from one level to another based on
daily/weekly points and behavior. Instead, each student meets certain
goals and gains certain skills in order to progress. While it is beyond
the scope of this article to describe the specifics, all of the
therapeutic tasks are keyed to the four universal needs of Circle of
Courage. Through this program, movement is self-paced. A resident who
wants to return home has only to finish the program (work through the
final therapeutic goals) to be successful. A resident who wants to
continue to try negative behavior may do so, with progress being that
much slower. Therefore, once a student completes the sequenced tasks and
is using the skills successfully on a daily basis, he or she is able to
move to the next level. Every youth has a folder where progress is
maintained, containing regular staff feedback as well as a
self-evaluation component. Youth receive personalized feedback in the
context of a caring discussion centered on the youth’s progress of
internalizing and demonstrating the Circle of Courage values.
Furthermore, youth can only move forward. Once a student reaches a
level, it cannot be lost. In this way, the new program acts more as a
road map for a journey than as an external reinforcement of behavior.
Students can work as hard as they want on therapeutic tasks,
individualized to their treatment plan. Results depend on their courage
to take ownership of their efforts.
Natural and logical consequences
So what are the consequences for discouraged and disruptive behavior?
Here, we again fell back on the Circle of Courage and on the principles
of Positive Discipline. We were determined to implement natural and
logical consequences as much as possible, over stricter and more
punitive methods. Consequences for problem behavior are determined
individually and are “natural” (e.g., failing a test not studied for);
logical whenever possible (e.g., cleaning up a mess before going to the
gym, researching and teaching peers about dangers of tobacco when caught
smoking, assigned extra tutoring when grades fall due to not doing
homework, etc.); and based on the youth’s needs. If disruptive behavior
is of sufficient gravity or involves safety concerns, privileges may be
temporarily frozen “though not lost altogether. Above all, consequences
are discussed calmly through a caring relationship, without berating.
They are presented as the results of a youth’s own choices.
Youth and staff buy-in
A major key to the success of the program was getting everyone’s buy-in.
This was accomplished in a number of ways. The big selling point was
that youth were responsible for their therapeutic tasks and the
successes they realized from them. With the traditional level system,
staff felt that student success had evolved into a staff responsibility.
Having youth become responsible for their program and treatment was an
idea welcomed with excitement. So was involving youth and all levels of
staff in the planning process. As the new program began to take shape,
continued efforts to disperse information and request feedback invited
its shared ownership among youth, staff, and task-force members alike.
Without youth investment, programmatic change would have been doomed. Gathering youth feedback about the old points system and involving their ideas in task force discussions was an important part of empowering and facilitating their ownership. Our youth-led Student Council gathered the initial feedback on point sheets and levels and compiled the results. After that, caseworkers and home-parents acted as liaisons between the youth and our task force as we forged ahead with shaping the new program. We continually tried to hear the ideas of the youth, as well as their underlying fears and concerns. Many of the fears, of course, involved control.
To further facilitate staff involvement and investment, information was exchanged through multiple, ongoing discussions between home-unit staff, larger treatment-teams, and their representatives on the task force. Everyone was given the opportunity to take part in the development process. Staff could give feedback during the team meetings or informally through phone calls, e-mails, and passing in the hallway. No ideas were shot down as foolish but were taken to the task force and discussed, with results being reported back to the concerned party. We repeatedly and consistently sought feedback. As the program began to take shape, staff also received four months of interactive and experiential training for it. Even at this late stage, the program continued to evolve based on staff input.
Transitioning current youth
The process of determining where a student in the old program would
begin in the new program involved a discussion with their staff during a
treatment team meeting. Each student was invited to make a presentation
(e.g., write a paper, make a display, formulate a debate) of which tasks
they felt they should begin. Each student was aided and accompanied to
this meeting by an advocating staff. Some students made remarkable
presentations. Others did not bother to read the program outline. This
helped the treatment team place them in the appropriate task. On the
whole, youth took the process very seriously. Most students read the
material and gave careful thought to where they needed to be. The
process was a good interaction between staff and students, with students
receiving affirming, frank, and candid feedback on their progress in the
program so far. Afterwards, most students were satisfied that staff had
their best interest at heart and had listened to them before deciding on
therapeutic goals.
Training
The Methodist Children's Home realizes that any program, no matter how
innovative, is dependent on having well-trained, qualified child care
workers. In collaboration with the task force, the training department
implemented a comprehensive training plan that built upon staff’s current skill sets and expanded their knowledge base for working with
troubled youth and challenging youth behavior. The training was designed
not only to comply with state and agency requirements, but also to
provide opportunities for personal growth and professional development
for each employee. Training sessions for direct child care staff began
four months prior to making the transition to the Spirit of Life
program. Staff were already trained to our strength-based model of care,
so the first phase of training provided an overview of the therapeutic
tasks to be completed by the youth, and related privileges.
The second phase of training shifted to how students would be held accountable for their behaviors without the use of points. Staff were provided specific Positive Discipline information, our primary tool for responding to youth. The principles of Positive Discipline incorporate our strength-based philosophy by emphasizing mutual respect, belonging, community, and encouragement. Positive Discipline is focused on long-term change, empowering solutions, natural or logical responses, and understanding youths” mistaken goals behind behavior. Our training was experiential and focused on helping staff to understand and apply these principles.
Our third phase of training for the new program built on staff’s prior training and understanding of permissible discipline techniques, especially understanding the difference between punishment and consequences. Under the previous point-based level system, points were sometimes used as punishment with little consideration to teach youth about consequences for their actions. The Spirit of Life Program allows youth to experience both positive and negative consequences for their actions, so that learning also occurs. The task force anticipated that establishing a relationship where consequences are discussed and explained, not dictated, might offer a difficult transition for staff accustomed to stripping away points. Therefore, in addition to Positive Discipline training, a Staff-Response Toolkit was created to guide staff in helping youth to manage their feelings and behaviors. This Toolkit is a handout offering several intervention models, all with clear steps for talking with youth, as well as multiple examples covering frequently encountered situations. The Toolkit provided staff with a three-step guide to responding to behavior by first engaging the youth with a verbal intervention, followed by the implementation of logical consequences, and then (if needed) the final step was a higher intervention by the treatment team for a continued pattern of behavior. Since the language used may be awkward or uncomfortable for some staff, we believed this Toolkit would provide them something to refer to and fall back on “if needed.
Our final phase of training prior to implementation reviewed how all of the Spirit of Life Program components work together to benefit youth. In order to provide staff with the necessary skills to implement a change within the new system, training had to incorporate a mixture of knowledge-based and skill-based instruction. Initial follow-up training has focused on teaching staff how to respond to student behavior rather than reacting out of anger, fear, power, or control. Training must continue long after the implementation of the program in order to further develop and support staff.
One step closer
Enhancing the relational focus of our youth interventions helps the
Methodist Children's Home move to the next level as a strength-based
program. Friedman (2005) asserts that healthy programs continuously
review themselves and are constantly evolving. With roots dating back to
1890, we have come a long way. The issues facing our current population
of at-risk youth require any innovative program to find better
solutions. We started this most recent transition with a desire to
enhance our strength-based philosophy by focusing heavily on
relationships, believing this applies to both youth and staff. Through
genuine caring relationships, youth and staff become open to
possibilities. Youth need to have input in the decisions about their
care, and staff need to have investment in agency activities outside of
their daily job descriptions. Empowering both youth and staff to
contribute to programmatic change has strengthened our agency.
The Spirit of Life Program is intended to
realistically prepare youth for a future outside of a structured
environment, giving them more responsibility and control of their
treatment but still offering structure and guidance for managing their
behavior. We took away a point-based system that was often misused by
punitive staff and implemented a relationally based road-map for success
instead. Getting to this point took research, communication, and even
debate. As an agency and as a task force, we had to expect greatness,
stay open-minded, set deadlines, and make sure staff had the support,
training, and tools they would need before changing the program. The
issue of control was ubiquitous, but we found that letting go of it was
the harder but wiser choice. Youth in residential treatment may be
challenging, but our experience suggests that less control in
combination with proper staff training may be the answer.
References
Brendtro, L., Brokenleg, M. and VanBockern, S. (1990, 2002). Reclaiming youth at risk: Our hope for the future. Bloomington, IN: National Educational Service.
Brendtro, L. and Shahbazian, M. (2004). Troubled
children and youth. Champaign, IL: Research Press.
Bullard, L. B. (2004). Are point and level systems the answer?
Residential Group Quarterly, 5, 1. pp. 6-8.
Friedman, T. L. (2005). The world is flat: A brief history of the twenty-first century. New York: Farrar, Straus and Gireaux.
Hatter, R. and Van Bockern, S. (2005). Transformational change in a treatment organization. Reclaiming Children and Youth, 14, 1. pp. 40-43.
Melvin, C., Korthase, N. and Marquoit, J. (2005). Beyond the behavior. Reclaiming Children and Youth, 14, 2. pp. 112-116.
Miller, W. R. and Rollnick, S. (2002). Motivational interviewing, Second Edition: Preparing people for change. New York: Guilford Press.
Nelson, J. and Lott, L. (2000). Positive discipline for teenagers. New York: Three Rivers Press.
Pike, D. R., Millspaugh, C. M. and DeSalvatore, G. (2005). Controlling behavior or reclaiming youth?: Creating a behavior management system based on the Circle of Courage. Reclaiming Children and Youth, 13, 4. pp. 213-217.
Smith, B. (2004). The price of coercion and compliance. Relational Child and Youth Care Practice, 17, 2. pp. 40-45.
Tate, T. F. and Copas, R. L. (2003). Insist or enlist: Adultism versus climates of excellence. Reclaiming Children and Youth, 12, 1. pp. 40-45.
This feature: Boldt, R.; Witzel, M.; Russell, C. and Jones, V. (2007). Replacing coercive power with relationship power. Reclaiming Children and Youth, 15, 4. pp. 243-248.
