The essential task of a profession is to deliver a service, and successful professionals must know how to give their clients exactly what they want. Whatever deceptions might be woven into this arrangement, the astute professional never loses sight of the fact that the “client” is whoever ends up paying the bill. So when groups of professionals compete within the same market, these criteria will identify the leader and, ultimately, determine the winner.
Within the so-called “helping professions” there can be no doubt that psychiatry, with its medical mystique and pseudo-scientific image, led the way throughout the 20th century. Having finally cast off its messy and costly flirtation with “psychotherapy,” it can justly declare itself the undisputed champion. Psychiatrists, and only psychiatrists, can now modify your thoughts, manipulate your emotions, and change your behaviour in the time it takes to fill out a prescription. Game over, as they say. To make their victory even more convincing, our medical friends can deliver these services to the satisfaction of the “client” at little or no apparent cost to the “consumer.” Rest assured that demand will always exceed supply.
In the final reckoning, clinical psychologists came in a poor and disappointing second. Their attempts to create their own mystique around batteries of meaningless tests and their efforts to turn their old cognitive and behavioural models into something useful never really brought them into contention. In fact, unless they abandon these pretensions, they may well end up losing out to the third-place social workers. While both groups maintain a certain popularity by sharing the psychiatric belief that consumers are victims of hostile forces and unfortunate circumstances, social workers are usually much nicer people. Not only are they always ready to bend a sympathetic ear toward the afflicted and the downtrodden, but social workers generally come much cheaper. And, if you’re about to place your bet, you might want to consider that they become particularly valuable whenever governments wish to show how much they care about those they purport to represent.
But, where does all of this leave child and youth care? Well, let’s face it, we were never really in the same league. Our feeble attempts to find a place among the scientific healers left us dangling somewhere between astrology and aromatherapy. And when it comes to developing standardized procedures and measuring outcomes, we still have much to learn from the plumbers and pipefitters. It’s true that we are still cheaper than social workers but, however much we might claim to understand children and youth, we lack the technology to “fix” them. While we continue to mumble about “self-awareness,” “presence,” “attachment,” and “relationships,” the kids we are supposed to care about are being marched off to the offices of the good doctors to be classified and medicated according to an ever-increasing configuration of diseases, disorders, and syndromes. And, as they say in the business, the money follows the label.
Forget all that old nonsense about drugs being an “adjunct” to the helping process; they are now the primary form of intervention. If we wish to maintain our fragile status as para-professionals, providing pre- and post-treatment care, perhaps we should join up with the nurses and learn how to say “thank you, Doctor” without disturbing the contents of our stomachs. We could continue to offer relational support for children who have been chemically induced into obedience and happiness, knowing that we are giving both clients and consumers exactly what they want. Safely on the bandwagon, we wouldn’t have to worry about bureaucrats spouting off about “outcomes,” academics demanding theoretical purity, and critics questioning our credentials. Though low on the totem pole, we would be part of a legitimate system that most of us have come to regard as a fundamental right.
There is, of course, another option. We could decide to step boldly into the 21st century by refusing to participate in servicing society’s addictions. We could take the position that our “problems” are not diseases to be eradicated but matters of our own creation, worthy of our curiosity, and critical for our continued growth. We could underscore the simple principle that all of our issues are created in relationships and can only be addressed through relationships. We could insist that every child be seen and heard as a unique human being whose experience of Self in the world needs to be acknowledged and understood. We could let the world know that our own sense of Self is our primary professional resource and that our “interventions” will always be shared experiences “meetings of Selves. We could demonstrate that it is possible to be with children without having to do anything to them and that this state of being contains all of the ingredients for healing and growth.
At first blush it may seem that such fuzzy ideas will never find a place in the technological and economic reality we have created. But, as Albert Einstein once pointed out, we cannot address current issues with the same ideas that brought us to this point. It might come down to a question of faith, but I truly believe that the old fortresses of depersonalization are beginning to crumble as our innate need for connectedness begins to seep through the foundational cracks. I want to tear those fissures wide open, to free the locked-in spirit and to hell with the consequences. I want to be part of a profession that has the courage to walk into the unknown and look with compassion on those who seek refuge in the comfort of prescriptions and the illusions of predictability. I want to be around when child and youth care workers stop using CYC-Net to ask about psychological tests and bipolar personalities, and when shrinks start asking questions about what it means to be “present,” and what it might be like for Mary Miles to live in the chaos of her particular family. I want child and youth care to lead the way, not by scrambling for a higher rung on the professional ladder, but by shining a new light into the darkness that lies within and around us all. And should we find ourselves relegated to the lowest point on the professional hierarchy, I will gladly live with the humility. I, for one, would take the freedom of the babysitter over the shackles of the nurse any day of the week.
In all of this, I find myself inspired by the words of the English playwright and poet Christopher Fry in The Prisoner:
The human heart may go the length of God.
Dark and cold we may be, but this is no winter now.
The frozen misery of centuries cracks, breaks, begins to move.
The thunder is the thunder of the floes, the thaw, the flood, the upstart spring.
Thank God our time is now, when wrong comes up to meet us everywhere, never to leave us, till we take the greatest stride folk ever took.
Affairs are now soul-size.
The enterprise is exploration into God. But what are you waiting for?
It takes so many thousand years to wake. But will you wake?
For pity’s sake.
This feature: Fewster, G. (1999). Editorial: A new light in old darkness. Journal of Child and Youth Care, 13, 4, pp. iii to v