A framework for understanding and practice in residential group care

James P. Anglin

This paper was presented at the NACCW Conference in Kimberley, South Africa in July 2003. (Note: This paper is adapted from Chapter 3 in the book “Pain, Normality and the Struggle for Congruence: Reinterpreting Residential Care for Children and Youth” published by Haworth Press, Binghampton, New York, 2002.)

It has been the case in at least one country, up until less than a decade ago, that Child and Youth Care workers were classified in the same occupational category as zookeepers for animals. (I would prefer not to name the particular country as this might unfairly imply that such a classification represents an attitude and understanding that is solely a phenomenon of this one nation.) Perhaps the assumption of such classification is that caretaking is essentially the same, whatever the setting and whatever the “occupants”. The findings of a recent research study on residential Child and Youth Care (CYC) work undertaken by the author (Anglin, in press) demonstrate how far from zookeeping and caretaking effective Child and Youth Care work can be, even though we must admit that some residences still appear to indeed function more at the level of a zoo.

The purpose of this study was to construct a theoretical framework that would offer an understanding of staffed group homes for young people that, in turn, could serve as a basis for improved practice, policy development, education and training, research, and evaluation. The method selected as most appropriate to the task of developing a theoretical understanding of group home life and work was the grounded theory method as articulated in a variety of texts by the co-founders of the method, Barney Glaser and Anselm Strauss (Glaser,1978, 1992; Glaser and Strauss, 1967; Strauss, 1987; Strauss and Corbin, 1990).

The development of grounded theory was influenced by the emerging tradition of “symbolic interactionism” (Blumer, 1969; Strauss and Corbin, 1990, p. 24). The emphasis on personal meanings, social interactions and interpretative process characteristic of a symbolic interactionist perspective is evident in the formulation of grounded theory (Glaser, 1992, p.16), and perhaps these aspects of human developmental life alone set the Child and Youth Care residential care task apart from zookeeping.

The basic aim of grounded theory is to generate theory from social data derived inductively from research in social settings (Strauss and Corbin, 1990, p. 23). Critical to the accomplishment of this purpose is a systematic gathering of data through the active participation of the researcher in the phenomenon of interest. The process of immersion in the data is sometimes referred to by sociologists as “indwelling”, and most aptly so in relation to a study of group homes. Such data gathering techniques as participant observation, semi-structured interviews, informal conversations and document analysis are typical of a grounded theory inquiry (Chenitz and Swanson, 1986).

Central to the grounded theory method is the search for a main theme, often referred to in the research literature as a “core category” or “core variable”, in relation to which most other aspects of the phenomenon of interest can be understood and explained. As Glaser states, “the goal of grounded theory is to generate a theory that accounts for a pattern of behavior which is relevant and problematic for those involved” (1978, p. 93). Thus the researcher is searching the data on a continual and comparative basis in order to discover a core theme that will serve to connect and place in perspective virtually all of the elements of the phenomenon being studied.

The core theme
The theme that was found to permeate the data across all of the homes and which encompassed the other major categories was congruence in service of the children's best interests. A group home may demonstrate congruence or incongruence to varying degrees across its elements, processes and overall operation, and it may do so with a variety of congruence orientations. For example, there may be an orientation toward operational efficiency, to the preferences of the staff, or to reducing the budget. In actuality, there are always competing interests and intentions within an organisation as complex as a group home, and full congruence throughout an organisation can best be understood as an ideal state never actually achieved in reality. In this study, each home was found to be engaged in what could be termed a struggle for congruence, and what was discovered to be at the centre of most of the struggles was the intention to serve “the children's best interests.” Related and virtually synonymous terms such as “child-centred” and “child-oriented” were also used by research participants to express this notion, but the children's best interests wording seemed most precise and evocative of the ideal being sought in practice. At the same time, while most of the homes in this study gave at least some evidence of holding this goal as an ideal, some of the homes clearly were not being guided in their work by such a focus. Further, no home was fully consistent in making all decisions on this basis (nor could one expect them to be), given both the competing interests that form the reality of group home operation and the natural variability of staff in their understandings and abilities to achieve congruence in their actions.

The concept of children's best interests has become a widely accepted notion in international instruments such as the United Nations Convention of the Rights of the Child (United Nations, 1989) as well as in the child welfare and child protection literatures in North America and the United Kingdom (Alston, 1994; Goldstein, Freud and Solnit, 1973, 1979). It is interesting to note that even the first book on residential Child and Youth Care published in North America by August Aichhorn (1935) includes the notion of acting “in the child's interest” (p.194) as a touchstone for Child and Youth Care practice. Therefore, it should not be too surprising that this longstanding and currently dominant concept was echoed in the words of some of the supervisors and managers of homes and agencies within the research sample.

Other major competing interests observed within the homes, and present in all homes to varying degrees and in various manifestations, included cost containment, worker preferences, and maintaining control. However, in this sample of largely well-functioning homes, it was evident that the core challenge was to achieve congruence in service of the children's best interests. The specific processes and interactions found to be most significant in creating such congruence will now be outlined.

Basic psychosocial processes
The ongoing comparative analysis of the data generated in this study revealed three dominant and pervasive psychosocial processes related to the central problematic of the struggle for congruence in service of the children's best interests. While each process is subsidiary to the main theme, each could also be viewed as a core category in its own right in relation to a sub-problem within group home life and work.

1. The most general, or pervasive, psychosocial process identified pertains to the overall development and ongoing operation of a group home, namely creating an extrafamilial living environment. The notion of an extrafamilial living environment, or “extrafamilial home,” captures a fundamental tension inherent in this form of setting and helps to clarify the group home’s unique nature in juxtaposition to foster care and institutional care on the continuum of residential services. As its name implies, a group home strives to offer a home-like environment not attainable within an institutional setting while removing the intimacy and intensity of a family environment. Much of the ongoing confusion and disagreement concerning the need for group homes can be attributed to a lack of appreciation of the importance of the “extrafamilial home” dimension. In this study, and as will be explored in some depth in a later chapter, group home managers and staff themselves frequently did not grasp the significance of this defining aspect of group home life.

2. At the level of the carework staff, the primary challenge was found to be responding to pain and pain-based behaviour. While the residential Child and Youth Care literature frequently
mentions the “troubled and troubling” nature of the youth in care (for example Hobbs, 1982), and acknowledges their traumatic backgrounds, there is a tendency to “gloss over” the deep-seated and often long-standing pain carried by these youth. The term “pain-based behaviour” has been coined to remind us that so-called “acting-out” behaviour and internalising processes such as “depression” are very frequently the result of a triggering of this internalised pain. Perhaps more than any other dimension of the carework task, the ongoing challenge of dealing with such primary pain without unnecessarily inflicting secondary pain experiences on the residents through punitive or controlling reactions can be seen to be the central problematic for the carework staff. One of the observed characteristics of a well-functioning home is a sensitivity to the need to respond effectively and sensitively to both the youth residents” behaviour, and their own personal anxieties. At the same time, few managers, supervisors and staff demonstrate an understanding of the underlying pain in the residents and within themselves. When it is brought to their attention, there is often a remembrance of the experience of pain, both the resident’s and their own, and a realisation that they have let this experience slide beneath their ongoing awareness. This intensive psychosocial process, and its frequent repression, makes acting in the best interests of the residents very difficult, and represents perhaps the greatest potential barrier to achieving a high level of congruence within the home in service of the children's best interests.

3. At the level of the residents, a third basic psychosocial process was identified, namely developing a sense of normality. As will be discussed in a later chapter, this psychosocial process not only captures the central task, or goal, to be accomplished by the residents, it also serves to define a key element of what constitutes the resident children's best interests. There is an apparent paradox at the heart of this process that can be confusing and worrisome to critics of group home care. How can an “abnormal” (or “artificial") living environment such as a staffed group home foster the development of normality? Won’t the residents simply become institutionalised in such an extrafamilial context? As will be discussed later in Chapter 7, what a well-functioning group home can offer residents is a sense of normality, thus providing a bridging experience in terms of the residents' readiness to engage successfully in more normative environments.

Each of these three psychosocial processes is closely interrelated with the others, and in reality they exist co-terminously as three interwoven threads or interrelated facets of the overall struggle for congruence within a home. To illustrate this point, a significant factor in a resident’s experience of developing a sense of normality will be the manner in which staff respond to his pain and pain-based behaviour in the course of creating and shaping the extrafamilial living environment. Further, these pervasive psychosocial processes are made up of many moment-by-moment interactions between individuals, and some of the most pervasive and pivotal of these interactional dynamics will be outlined next. These interactional dynamics provide an important means for understanding and assessing the degree of congruence throughout a group home organisation and its functioning.

Interactional dynamics
On the basis of a comparative analysis of the interpersonal interactions occurring within the homes as noted during the on-site visits and discussed in interviews, eleven dynamics emerged as most pervasive and influential. This category of interactional dynamics identifies the most significant modes of relation between persons within and connected to the group home. These interactional dynamics can be understood as the key relational ingredients of group home life and work and as elements of the larger psychosocial processes already identified. Briefly stated, the dynamics include the following:

(a) listening and responding with respect;
(b) communicating a framework for understanding;
(c) building rapport and relationship;
(d) establishing structure, routine and expectations;
(e) inspiring commitment;
(f) offering emotional and developmental support;
(g) challenging thinking and action;
(h) sharing power and decision-making;
(i) respecting personal space and time;
(j) discovering and uncovering potential; and
(k) providing resources.

Each of these interactional dynamics can come together with various others in a single moment or episode, much in the same way as various ingredients combine in the preparation of different culinary preparations. The creation of a residents' best interests environment can be seen to be largely a matter of combining these interactional ingredients in a highly congruent manner, while sensitively addressing the three major and intertwined psychosocial processes of creating the extrafamilial living environment, responding to pain and pain-based behaviour, and developing a sense of normality.

Finally, one additional category was also found to be important in completing the framework for understanding group home functioning; namely the levels of group home operation.

Levels of group home operation
Organisations such as group homes are not simply assemblages of people, paper, procedures and premises. As the term “organisation” suggests, these elements must be brought together in an organised fashion. As with most such settings, group homes consist of a hierarchy of operating levels, or domains, each with its defined set of roles and responsibilities. In this study, five such levels were clearly evident as reflected in participants” ongoing thinking and action within the homes.

1. Extra-agency level (contracting, funding, liaison etc.)
2. Management level (administration, budgeting, resource allocation, personnel management, etc.)
3. Supervision level (overseeing careworkers, team development, programming, resident care, etc.)
4. Carework and Teamwork level (working individually and collectively with youth and family members, completing reports, linking with community agencies, etc.) and
5. Youth Resident and Family level (daily living, visiting, etc.)

The word “levels” rather than “domains” will be used to reflect more explicitly the hierarchical nature of these operational dimensions. In the next chapter, the notion of a flow of congruence from the higher levels to the lower levels will be identified and explored as an important aspect of the core category of congruence in service of the children's best interests, and how it comes to be realised (or not) in actual practice.

Conclusion
It is proposed that this theoretical framework can assist not only in determining the degree to which a group home is well-functioning or poorly functioning but also in identifying areas of specific strength and weakness. Thus, it offers a theoretical tool grounded in the realities of group home life and work to assist in enhancing practice, drafting sensitive policies, targeting standards, ensuring the relevance of education and training, focusing research, and guiding evaluation.

This feature: Anglin, James P. (2003). A framework for understanding and practice in residential group care. Child and Youth Care, 21, 10. pp. 4-7.