Thom Garfat writes: In an editorial in the Journal of Child and Youth Care, we described a scenario in which a mother confronts a child and youth care worker with a question. The woman's child, Billy, was about to be admitted to a residential treatment centre, and she wanted to know, “What is it that you child and youth care workers can do that all the fancy help I’ve paid for hasn’t been able to?" She warned the worker to keep it simple, saying, “I go to sleep when people use too much jargon."
Rather than try to respond to Billy’s mother’s question, we asked readers of the Journal to let us know how they might respond to her. We were a little anxious that no one would answer our call but we decided to take the risk anyway. It was well worth it! Replies to Billy’s mother came from all over. They came from Labrador to Alberta and from Detroit to California; they came from students, from front line workers and from seasoned teachers and trainers. What follows are some examples of how people in the field might reply to Billy’s mother. We have not edited, screened or censored these replies. We share them with you for your pleasure and learning, and, ultimately, in the hope that they might stimulate you and your colleagues to discuss these important questions.
From the trainers
Floyd Alwon from the Albert Trieschman Center in Needham, Massachusetts sent along his reply to Billy’s mother. In sending his response Floyd warned that we might find it “a bit hokey.” Well Floyd, it’s hardly “hokey.” Instead it offers us some very important insights into how, not just why, we could enlist a parent’s support and involvement in our work with the child.
You ask an excellent question – one that indicates care and concern for your child's well being. You also hint at your frustration with the many professionals who have already been involved with your son and your family throughout the course of your family’s difficulties.
Although there are no easy fixes to serious difficulties, residential treatment provides a unique opportunity to help youngsters who are often unable to be reached through other means. To begin with, residential treatment is a substantial intervention in a child and family’s life. It dramatically underlines for all involved that things are not working and that some “better ways” need to be found. The structure of the residential centers with their predictable routines and activities geared to the child's development level, typically helps to reassure children that they can relax.
In addition to the unique structure of a residential program, the major therapeutic impact is delivered through the person of the child and youth care worker. These are individuals whose primary purpose is to enter the “lifespace” of the children and assure that the environment is responsive to the special needs of the individual children in the group care setting.
Child care workers are in a particularly unique position because they typically do not have to concern THEM: selves with the other hassles of managing a household. Parents, for example, must concern THEM: selves with bringing in income to support the family, taking care of the housework, cooking, laundry, and all the other tasks that go into being a good parent. While child care workers do engage in and help youngsters to learn how to be more responsible for household chores, the primary focus for the child care worker is to establish a therapeutic relationship with the child. This allows the worker to better understand the issues that the child is struggling with and to be available to help that child as the issues come up in the “lifespace.”
Most residential programs also have other specialists who work with the child care worker. These team members bring a variety of perspectives and skills as resources for the child and family.
We will welcome your involvement in the care and treatment for your child. I hope that you would have opportunities to be on shift to observe the setting prior to your child's admission. A chance to talk to other parents might also be helpful. Frankly, I am quite pleased that you have concerns and are able to express these openly. This is a sign that you are caring for the future of your child and family.
My most important piece of advice, however, is that you need to know that you have the power to make this placement succeed or fail. In my many years in helping children and their families in residential treatment centers, I have never seen a placement “work” if a parent does not actively endorse the placement. This does not mean blind trust. Rather, it means that the parent tries hard to co-operate with the staff as a member of the child's treatment team “the most important member of that team. You will continue to have questions and doubts about the placement decision. Your child knows this and will be sure to test out how much you really trust these people. Give your son, the program, and your family a powerful opportunity to change what hasn’t worked well for you and your family. I wish you and your family the best of a new beginning.
* * *
Mark Krueger, from the Child and Youth Care Learning Center in Milwaukee, who is known to all of us as a regular contributor to our field gives us a reply which is profound in its simplicity:
My first response is that as a child care worker I’d never have my office set up with my desk in between me and my client... so it would be impossible for anyone to enter my office and find me behind a desk. I have the front of my desk against a wall and the door open.
My verbal responses would probably be something like: “I guess we all feel like giving up sometime.” “It’s hard to be a parent sometimes.” Then later, “Parents need support and so do we. We’d like to work together with you to help Billy.”
* * *
Lorraine E. Fox, from San Clemente, California, was flying somewhere on one of her many training missions when she realized that she had forgotten to get back to Billy’s mother. Rather than just let it go Lorraine sent off a letter to the boy’s mother in which she responds in great detail to the question. We know that Billy’s mother will be grateful not only for the detail in Lorraine’s response, but also for the honesty. I know we are.
Dear Billy’s Mom,
I apologize for the delay in getting back to you about what makes Child and Youth Care Workers different from other helping professionals who work with families like yours.
I put it off for lots of reasons (some of them pretty good, actually). One reason was that I’ve been working in Child and Youth Care for 26 years and I thought that I should write up something pretty sophisticated or classy. A friend of yours and mine called to ask about the delay and told me to just take a few minutes and write what came to me. That’s what I’m doing. I’m on an airplane now flying very close to where my friend lives, and I decided to just do it. You know, the truth is that it only took a few minutes to be able to fill up a couple of pages with differences. Our friend said that you tend to doze off when anyone starts talking to you using “psychobabble,” so I’m going to spell out the similarities and differences in very simple, down-to-earth terms that I hope will make it clear that there is a very good chance that your son, Billy, will be able to get some of the help he needs in a Child and Youth Care Center.
Before I begin, let me tell you something about myself so you'll know who’s taking to you. I’m a woman, and I’ve been trained as a psychologist (Doctor) and I’m also trained and certified as a Child Care Worker. So, I’ve worked with people like you and Billy both in outpatient “walk in “settings, and also in residential settings. I can assure you first hand, that both kinds of help can be very effective, and both kinds of help can be very destructive. That’s why it’s so important that clients “people like you “ask the kinds of questions you’re asking! When people are hurting the way you and Billy are, it’s frankly easy to get hurt again by so-called “helping" people. Think of it this way, when you look at the degree of your medical doctor, dentist, psychologist, or social worker “you can’t tell from that if they were in the group at the top in their class or in the group at the bottom. (That’s why people hang their degrees and not their transcripts on the wall!) Well – you asked me to talk to you without any b.s.
Anyway – you’re right to question, and to be cautious and concerned. I wish more parents were! And since it sounds like you've been around the block a few times – as far as having people and systems meddle in your life – I think you'll be able to understand the difference.
It is my opinion (many might disagree) that many of the therapeutic skills and personal qualities needed by a competent CYCW (Child and Youth Care Worker) are the same as those needed by a competent social worker, special education teacher, or psychologist. What will differ is the application of these skills. The “why” and a lot of the “what” that we (CYCWs) do are similar; the when, where, and how will sometimes differ only slightly and will sometimes differ considerably.
Many of the differences are fairly clear. Let me outline them for you in a THEM: (other professionals) and US: (CYCWs) format.
THEM: Most helping people you are familiar with are members of established professions. There are standard educational requirements, and they've been around with their current status for a while.
US: CYCW is an emerging professional. To be honest, we’re not really a profession yet, by conventional standards. But we aim to be. We've got away to go, but we’re definitely moving.
THEM: Other professionals have achieved social recognition and are fairly well understood. Mothers of other professionals are proud.
US: CYCW has not yet achieved wide social recognition and is not well understood. Mothers of CYCW’s are often puzzled.
THEM: Members of all other professions have credentials that they can hang on the wall.
US: CYCW’s have their primary credentials in their hearts – in addition to, or often instead of, credentials suitable for framing.
THEM: Most professionals have an office of some kind and most professionals (therapists, lawyers, doctors, and nurses), operate for the most part in their space: i.e., clients will work with the professional in a setting that more or less “belongs” to the professional (office, court, hospital, etc.... )
US: CYCW's do almost all of their work in the lifespace of the child (client)! Instead of teaching and counselling on comfortable chairs CYCW's do their teaching and counselling in vans, at swimming pools, around the dining room tables, on ball fields, while walking or running.
THEM: Most professionals do their work with clients by appointment.
US: CYCWs do all their work during and as part of the child's daily life activities
THEM: Most Professionals have their own desk.
US: Most CYCW's share a desk with 6 or more other workers, and furthermore can't seem to find the time to sit at the desk even when its available.
THEM: Most professionals have time limited interactions with clients.
US: CYCWs are “on duty” 24 hours a day, and each individual CCW is “on duty” (whether s/he chooses to accept it or not) when s/he is around the children or youth in care.
THEM: Most professionals who provide one to one, group, or family counselling have the freedom to focus on that particular individual or family during the counselling session.
US: CYCWs provide a lot of counselling, but while attending to the individual, they must also attend to the entire group in their care (focus on the individual, focus on the others in the group, focus back on the individual don’t forget to remain alert and available to others in the group, focus back to the individual... ).
THEM: Most professionals provide group therapy in group therapy sessions.
US: CYCWs more often provide therapeutic interventions in “action groups.”
THEM: Many therapeutic helpers provide emotional
comfort for children and
youth by relaxing limits.
US: CYCWs must learn to develop and maintain a therapeutic atmosphere, and provide emotional comfort, while establishing and maintaining firm limits.
THEM: For most professionals with therapeutic responsibilities, their treatment skills are all important.
US: The CYCWs, in addition to needing treatment skills, must also cook, clean, sew, drive, recreate, do homework, fix toilets...
THEM: You can usually tell when a professional is dressed for work.
US: CYCW’s are often “dressed” for work in jeans
THEM: Most professionals are seen from the front.
US: CYCWs are always seen (... and studied) in the round.
THEM: Most professionals are paid far above minimum wage.
US: Many (most?) CYCWs are paid at, close, or not that much more than the minimum wage.
THEM: Most professionals are well trained.
US: Most CYCWs are poorly trained (for their complex task).
THEM: Many professionals are over-sophisticated (and can be somewhat “removed” from the grinding realities of their client’s lives).
US: Many CYCWs are under-sophisticated (and can be tempted to approach their role as more custodial than therapeutic... missing many precious opportunities for healing and helping).
THEM: Most professionals are supervised by people with similar training and qualifications.
US: Many – if not most – CYCWs are supervised by people from other professions.
THEM: Most professionals see their function with clients, and kids like Billy, as separate from or supportive to the parenting function that you provide.
US: CYCW’s must provide parenting functions simultaneously with all their treatment functions.
I hope these comparisons are helpful. I also hope that from this description you can see why Billy is very likely to get the help he needs if he is placed in a center with a caring and well trained staff. Here’s my advice – you'll be able to tell how Billy is being treated by the way you are treated. So pay attention to your feelings when you visit Billy, and pay attention to how the staff conduct themselves and relate to you and Billy. And keep asking questions. It should be obvious from my comparisons that there are no guarantees and that there are considerable differences between facilities. Look for one that is open to your questions and open to your visits. Ask about staff qualifications. And watch. If Billy is placed in a center with competent staff, remember that they will be with Billy around the clock, helping him at all hours and with all of life’s tasks. And this gives you a reason for a lot of hope. Good luck!
* * *
In keeping with the evolving Child and Youth Care tradition of seeking input from the children with whom we work, we wanted to end this piece with a response from a child. So, we asked the question of a child in a residential treatment center. Rather than trying to summarize her reply (which is verbal because she, like so many children in care, has difficulty in writing) we thought we’d offer her response in the same form in which it was given. Her name is Paula and based on her numerous years of experience with helping professionals, this is what she had to say:
T.G. “So, Paula, what do you think? How do you think child and youth care workers are different from the other people who have tried to help you and your family?”
PAULA “Well, I don’t know. I guess they’re different because they talk to you. And they care for you. And they help you too.”
T.G. “But, didn’t all the others talk to you?”
PAULA “Well sure... but it’s like you didn’t exist if you know what I mean. Like they didn’t really listen.”
T.G. “Well, okay, but the others probably cared for you too.”
PAULA “Oh, sure. As long as you weren’t late for your appointment.”
T.G. “Funny, Paula. But surely the others helped you in some way.”
PAULA “I guess so. At least my dad said they did. But they never really help me in important ways, you know... like I never really learned how to do anything really important like get along with my mom or stay out of trouble. It was the child care workers who helped me learn how to do that. Can I ask you a questions now?”
T.G. “Sure Paula. What is it?”
PAULA “Why are you asking me all these questions? Are you insecure or something?”
T.G. “Well, Paula. Maybe we are. Why do you ask?”
PAULA “Because you shouldn’t be.”
T.G. “You’re right. Thanks for helping us out.”
Garfat, T. (1989). Chasing rainbows for a definition. Journal of Child Care, 4(3), v-vii.