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Selected Readarounds in Child and Youth Care

ListenListen to this

The child care worker as a primary practitioner

F. Herbert Barnes

I am told that there is a need for child care workers in South Africa to see their role as something which has an authentic place within the residential treatment repertoire and that this is something which needs to be worked on at this Conference. This makes me feel right at home for it seems that those issues in child care work which are important to you today are issues which have interested me for quite some time in my own country. We, too, have – and have had for years – questions of whether child care work is a profession or merely a trade. Certainly it is vital to children, youth and the organizations that serve those in need of specialized treatment programs. That question has intrigued me for years and if we have the opportunity to address that question here at this Conference with Dr Eisikovits’s participation, we may find that it is a craft. It is a worthwhile question, but it is not the question upon which I have worked most energetically. Rather I have sought, both through information-gathering and experimentation, to develop a conceptual design for the kind of child care worker role that appears to be needed, particularly by the children in residential treatment settings, but needed also by those administrators and members of other disciplines who wish to use residential treatment settings as environments for growth and change. As I have done that work it has, quite frankly, led me to the conclusion that this is a profession we are talking about, for there is a knowledge base pertaining to child development, group process, individual treatment, ages and stages of growth. clinical assessment, curriculum for individuals and groups, law, regulations and policy – all of which the kind of child care worker that I would like to see in operation with children and youth must have. There is a way to define practice and to identify specific responsibilities which, when examined, become distinctly professional in nature and in their aggregate, unique to this work. I will be discussing those elements with you in this paper.

However, there is also an element of art to this work – a flair for the dramatic, a sense of timing, a cultivated, even disciplined, intuition, and a well-regulated enthusiasm which we might call sophisticated naiveté. Perhaps that really defines this work as a craft. It is quite debatable and I hope we have the opportunity to debate it.

But first let me share with you the background from which I conclude that child care work, to be effective, must be and can be conceptually clear as to what it is and what it is not – the concept of role. Then I would like to discuss what child care does and how it does it – the strategy for practice. It is my belief that such an elaboration of role and practice will show not only that child care has an authentic place in the residential treatment repertoire but that, in those settings which opt to use the living experience as the primary vehicle for fostering growth, and will use the continuing parade of daily events as curriculum for promoting competence, it will be found that the child care worker has a critically important role the only role in fact which is absolutely central to the work of residential treatment.

I am particularly pleased to do this in the framework presented by the conference organizers, namely to look at it in its widest context – team, task, the child in treatment, and his family. For too long this role has been accepted solely as care-taking in institutions. The wider context – even extending the field for practice to non-residential settings, community-based programs, street programs, crisis services, out-patient clinics, specialized youth services – permits a more substantive definition of this work that can make it teachable to beginners, critiqueable to advanced practitioners and accountable to performance standards and outcome expectations.

Revolutionary elements and conceptual issues
Residential programs have long been a part of the basic fabric of child welfare services. Many have evolved into the current era from the orphanages and asylums of earlier times. These evolving institutions have made differing use and definition of child care workers depending on what they have evolved into.

The situation which prompted this evolution in the United States was well described as early as 1964 by Hanshel Hollingsworth: "The child-caring institution has children in care primarily because of their need of supplementary or substitute care to compensate for inadequacies of the family in respect to its child-rearing functions. Disturbances of the children range from mild to fairly serious.

The children in today’s institutions are from homes suffering any number of physical, social or emotional ills. Many of the children are also unwanted or unwisely loved. Among them are the withdrawn, the lonely, the angry, the defiant, the truthless and the faithless. It was not without pain, something following ostrich-like behavior that institutions faced the fact that the nice children of old were remaining at home with various community supports available to their parents .

As a result, large numbers of children with greater difficulties are being brought to institutions by parents, courts, clinics and child welfare workers. Institutions are currently being asked to make the most difficult decisions they have ever been asked to make. In the past they were often accused of being too selective. While some others were clinging doggedly to serving healthy youngsters, others were sincerely afraid of the child with problems.

As early as 1953, Bernard Scher, then Director of Group Residences for the Jewish Child Care Association of New York, said that: "A major change in the old, familiar institution for children has been going on . . . It is only a slight exaggeration to say that the old asylum for normal dependent children is dead, or should be. Fewer ‘normal’ children are coming into placement and those would be better served in foster home care. As a result, institutions have had to choose to change their role or to provide what is at best a second-rate service."

This great pressure to convert the old asylum to a specific instrument led directly into the evolving pathways of professional development in the United States, and the skills that were being introduced into the field of child philanthropy were those of such disciplines as psychiatry, psychology and psychoanalysis – clinical skills which emphasized study, diagnosis and treatment, with treatment usually implying one-to-one psychotherapy or clinically-based, insight-oriented group therapy. This caused a great impact on the general child caring institutions, an impact which we in the United States are really just now recovering from. The ‘best’ institutions became residential treatment centers and, because of the above demands, began to bring specificity to the work through the use of the medical model and its goals as a basis for defining purposes of placement, staff roles and programmatic operation. Children were placed to be ‘cured’ in mental health related facilities or ‘corrected’ in juvenile court and corrections related facilities. Child care workers, not identified among these health disciplines and not a direct part of the clinical undertakings, were perceived solely as caretakers, as peripheral supporters of the ‘real’ work of the institution. Lacking a ‘professional’ task on this treatment team, child care workers also then lacked a dynamic, specific definition. It seemed to be sufficient to say, ‘Well, child care workers are like parents'. Since their main task in these kinds of settings was taking care of the children while the professional treated them, there appeared to be a self-evident rather than conceptual definition of the role. And the use of this definition further supported the locating of professional expertise elsewhere than in the living situation itself.

Though the interactions of the three major mental health professions – psychiatry, psychology and social work – in the construct of the orthopsychiatric team and the separation from the team’s clinical deliberations of the nitty-gritty of daily living and the children’s caretakers has been called milieu therapy, it is my belief that unless there is a new team defined that is comprised of members who deal directly with residential youth in their daily living experiences and includes the specialist mental health disciplines as technical assistance resources rather than dominant figures, there will not and cannot be milieu therapy. At best there will be clinical treatment provided to an aggregate of children and youth who are provided a managed living situation while participating in therapeutic experience that is essentially outpatient therapy provided to an institutionalized population. Until such time as the child’s daily worker, that person/those persons who live with him, do things with him, get him up, set limits for him, eat meals together with him, those persons who know his frustrations and his interactions with other people, both adults and peers, who help him handle his daily stresses and support the progress he is making as that progress manifests itself directly in performance – until those persons are in primary positions of responsibility on the team, it is hard for me to believe that there can actually be a truly therapeutic milieu – that there be residential treatment rather than clinical treatment of people in residence.

It requires more than ‘being like parents’ if that is to be done. It requires workers who can provide to the child a conscious use of self that is based on an in-depth knowledge of the child’s psycho / educo / social /developmental needs. And there must be a construct to encourage and define this.

Why is it that we have so linked the child care worker with parenthood, and therefore settled that he is not a professional, or at best, para-professional? It is not because he alone is concerned with the child’s general welfare or that kids need care. Psychiatrists and social workers are caring people. Yet they never perceive their roles as parental even though they care about their clients, do many supportive and loving things, set limits with them and have a genuine concern for their clients’ total wellbeing. They simply don’t have the Catch-22 of the child care worker. They don’t live with their clients. The minute the phenomenon of living enters, someone must be the parent it seems. It is interesting, however, that this mythology operates only in institutions. It in no way obtains in summer camps even though kids live there. Perhaps this truism is kept alive because it is all we know as a model, and we have simply built around that. Perhaps it is some sort of conviction that all kids must grow up in families, even those who can’t, and if we have to we’ll fake it. At any rate, it is obvious that we are ambivalent rather than clear. It is obvious that we have known that we need a skilled milieu worker for a milieu, yet lacking the incentive for clear conceptual alternatives, the role often continues to be linked with parenting and to have many false remedies proposed for improving the lot of child care workers.

These remedies have covered the spectrum of ‘solutions’, such as ‘give them more status’, ‘call them paraprofessionals’, ‘put them on the treatment team’, but it is now abundantly clear that those ‘remedies’ have simply not succeeded in vitalizing the role of the person who lives with the kids and lacking that, it is often too apparent that the role of the residential child care worker is an unconceptualized role for a non-trained person to do a poorly defined thing. But, this ‘thing’ is something which is absolutely vital to the lives of thousands and thousands of children and youth who are residents of children’s institutions, residential treatment centers, hostels, training schools and child care centers.

What is actually needed is:

  1. The formulation of a structure for the experience of our residential youthful clients in which the wide variety of ingredients of daily living, including the humdrum to the unique, become valuable curriculum for growth and behavioral change, and

  2. The formation of a conceptual design for the role and practice of a professionally responsible person who will manage this curriculum, who will inter-relate the helping processes of both the group and the individual, who will integrate the totality of this experience into the totality of each child and, lastly, who will be broadly concerned with integrating the child with his own ecological system.

This would be a worker with a clear task definition of integrating a child’s total experience’ in residence – his specialized treatment needs with his normative requirements for social, educational, work and recreation experience. With a clear task definition which differentiates the worker from other persons significant to the child, the worker is disentangled from the role of parents and free to work with parents as well over a range of interventions and support services including: providing information about their child’s progress; providing interpretation about their child’s behavioral dynamics; establishing and facilitating parent peer support groups and providing individual counselling to help parents make maximum use of groups. Through direct and support, services the professionally defined milieu worker would focus on empowering parents in their parenting roles. But the worker must not be perceived as doing it all himself. Collateral disciplines are vital. But he must be perceived as the chief integrator and a major facilitator. The discipline of this kind of child care worker is a specialist one, unique however in that it makes the general its speciality.

Practitioners of this sort must he able to digest a social history prepared by the social worker. They must be able to derive direction from findings of psychological testing. They must be able to formulate remedial programs and design interventions from the findings of psychiatric evaluation, educational testing and family systems analysis. Such practitioners must be able to assess the capacities of their own program and synthesize all this data into a working knowledge of the child, his needs, and a plan for how they can be met. But first and foremost, such practitioners must be able to relate warmly, effectively and in ways that are conscious yet not lacking in spontaneity, and be able to engage with children and youth in a range of activities which are of interest to and appropriate to youth. This then is the basis for milieu therapy – working in the life-space of the client rather than the office-space of the clinician – and without that capability for using the totality of the experience to achieve milieu therapy, there appears to me to be no justification for placing young people in institutions. If there is not something truly unique going on there – something that very specifically does utilize the group living experience and the social system of the institution for re-education, socialization or treatment – then I contend that all other ingredients provided to youth in institutions (care, meals, psychotherapy, psychological testing, special education, group therapy. play therapy, work therapy, recreation therapy) all these ingredients can be provided outside the institution.

Paul W. Perch described this a decade ago in an article in the International Child Welfare Review. He stated:

"There has been a rather strong tendency to consider treatment as synonymous with individual treatment. When the treatment approach was first introduced into institutional settings, we more or less took over the model of individual clinical treatment. An institution ought, however, to be considered as a functional unit or a social system formed by the interpersonal relations between its inmates. That is to say, we must use a broad sociological and socio-psychological frame of reference when we try to analyze what institutional treatment is. In our most progressive efforts at individual treatment and casework, we have perhaps been apt to forget that institutional life is group life."

Anna Freud, Joseph Goldstein and Albert Solnit, in their recent book, Beyond the Best Interests of the Child addressed this issue and identified the need for a particular kind of worker. They define the issue and express the need as follows:

"Whether in residential or community settings, the importance of an integrated, milieu approach is widely acknowledged, as is the need for child advocacy in the sense of prompting environmental conditions that will make it possible for a youngster to succeed. Where these functions cannot be effectively orchestrated by youngsters’ natural parents, whether due to parental problems or to those of the youngster, society should be prepared to provide carefully selected substitute parenting figures. both in the child’s interest and its own."

Healthy families provide the administrative or coordinating function that makes it possible for the child to integrate his or her experiences at home, at school, on the playground, in the scout troop, in the community and , if necessary, in various treatment settings. It is in this function that we find the real coordinate between the parent and the child care worker. It is not that the child care worker is like a parent, or that the child care workers role can be described by describing that of parents. Rather, it is that parents, and child care worker’s unique among other professional disciplines, each have the executive function regarding care, nurture, guidance, and growth of children at their very core. Lacking this kind of professional definition of the role and responsibility of the child care worker this kind of help is not available to children when parents are unable to provide the central role.

Lacking this, children are left unaided in making sense of and dealing with the contradictory demands of complicated settings, or the confusion of community influences. This is a natural consequence of the fact that existing professionals who work with children tend to be specialists whose backgrounds have trained them to focus on pathology rather than on the totality of a youngster’s situation and development.

The ‘clinical team’, as we have always known it, is interdisciplinary, yet no discipline comprising this orthopsychiatric team is an advocate for the child as a whole. We have not as yet developed a professional who is trained and competent as a specialist in working with the full range of a youngster’s experience. Nor have we been able, despite the need, to design and implement a professional role for this kind of specialist. There is no one trained and available to look at the child and his environment, and to work with him to mobilize and integrate these factors in the service of his development. We possibly haven’t developed it because we have been held back by what we already know and do so well. The earlier established mental health and human disciplines and the historic tie of child care work to the notion of parenting (while omitting conceptual recognition of its most dynamic ingredient) have prevented a development of professional child care work equal to that of other developed and functioning professions.

The Federation of Protestant Welfare Agencies of New York City was concerned also with this same subject and in a report of their study and recommendations this point was made:

"There must be a helping person who gets to know the family where children are in jeopardy, who works for an agency which has as one of its important purposes assuring good care for children; who has the time and understanding required; who will stick with the family as long as services are necessary, and who has the ability both to provide direct help and to facilitate the use of community resources on behalf of the family. This kind of helping person is especially needed in the kind of large complicated urban setting in which we exist; and this service is largely lacking. There can be no question that the well-being of thousands of children depends upon our ability during the next few years to create a service of this kind in a large enough volume to assure their proper care and protection."

George Albee, a professor at the University of Vermont in Burlington, Vermont supported this point of view. In an article in the American Psychologist (1968) he stated:

"If we continue to use the illness model of mental disorder, we cannot produce a fraction of the medical and para-medical people the model demands. This would not be sufficient reason for abandoning the illness model, if it were supported firmly. What I am suggesting is that we are in a manpower cul-de-sac because of the conceptual model we use. The development of alternative models could lead to new manpower solutions because they would allow for new institutional solutions requiring manpower more easily recruited and trained."

Roderick Durkin, Director of the Sage Hill Camp in Jamaica, Vermont, spoke recently to a Canadian Child Care Workers Conference held at Banff, Alberta and expressed his belief that:

"there is an inherent dilemma in trying to raise and treat children in the same setting, and the choice of emphasizing treating – i.e., focusing on pathology in a disease or medical model as opposed to emphasizing the raising or promoting normal growth or development – has proved a mistake. Many say the medical model doesn’t exist now that we have the team approach. In reality, however, the team approach is little more than a new version of the medical or psychopathological model, where psychologists, social workers and child care workers can now all focus on pathology."

He goes on to use a famous quote of Abe Maslow’s to illustrate "the chief problem with the perspective of the psychopathological model for a residential setting", for youth, "if one’s only tool is a hammer (psychotherapy) one treats every problem as if it is a nail" (pathology in need of cure).

Other experience – other ideas

Educateurs, Orthopedagogues, Erziehers, etc.
In Europe other patterns have evolved and the results have been enlightening. It is probably safe to say that there is a main tool in residential youth work. It is psycho education in French, Orthopedagogy in Dutch and Scandinavian thinking, Erziehung (drawing out and guiding) in German. However, this seems different from Maslow’s hammer requiring that all problems be nails. These approaches are more developmentally based than pathology based. They are, in their context and operation, more normalizing than problemizing. Though able to deal with pathological attitudes and dysfunctional behaviors, these approaches seem not to concentrate on them.

Serge Ginger, while Chairman of the Technical Committee of AEJI (Association Internationale de Jeunes lnadaptes, the International Association of Workers with Maladjusted Children) described this approach as follows:

"Where the aims are concerned, it is a task of acting on a person in the light of a social environment (to help the individual to become himself while still being one of the group but not necessarily conforming completely)";

"Where the means are concerned, it is a question of overall action through constant contact based on a more or less shared day-to-day existence (‘constant contact practitioner ‘or ‘day-today activity therapist’".

He stated also that

"it should be possible to find a single definition acceptable to all cultures (whether they work in residential institutions or in the natural environment and whether they are responsible for specific activities or not) which should nevertheless allow for a distinction to be made between related professions such as therapists, social workers or teachers."

Thomas E. Linton, Professor of Education now at the University of Illinois, Chicago Circle, was one of the first Americans who studied and defined the educateur of France as part of his search for improving American youth services through articulating improved theoretical models for the role and practice of child care workers. He presented his findings in a monograph entitled The European Educateur Program for Disturbed Children and later incorporated many of them in a special volume of the International Journal of Mental Health. (1) I quote from the monograph:

"The educateur movement had its inception during the Second World War, which produced a large number of neglected and abandoned children. Individual leaders established centers for these children and soon realized the imperative need for trained youth workers to serve as model adults and substitute parents. There had long been a tradition in Europe of training youth workers in pedagogical theory and practical activities to work with young people in their leisure time, so the wartime camps for displaced children began to develop training programs for their workers. These incorporated a good many of the conceptual and practical ideas which. had characterized the pedagogical training models for many years.

It is in this area that a major difference exists between the European concept of educateur and the traditional American concept of social worker, teacher and houseparent. The educateur is not a case worker, nor is he specially trained in diagnostics and therapeutically handling the maladjusted child. He is not a teacher who is attempting to instruct the maladjusted child and bring him up to a particular academic level. And, finally, he not a traditional houseparent or ward attendant who attempts in an uniformed way to control the behavior of his wards. He is, rather, a highly trained professional youth worker who is primarily concerned with the total life process of the individuals in his group. He is trained to utilize all the leisure moments of a child’s life, to program this free time in a manner that directly engages the child’s physical, moral, social, and intellectual development.

The concept is simple. The educateur is the closest one to the child from the time of rising in the morning to going to bed at night. He is responsible for the child’s total behavior, and his involvement with his group is expected to be not only professional but personal in the sense of concern for their daily welfare.

Theoretically the idea is to reach the child through the activity. The activity is not the goal in itself. It is the means through which the child and the educateur can arrived at shared interests, human understanding, and behavioral modification. Emphasis is placed on the value of the activities both in coping with the problem behavior and in the positive channeling of misdirected energy. The total day and week in the institution is preplanned by the educateur, allowing for the individual interests of the children. This planning assumes that programming and activities are nearly synonymous concepts. A large range of activities during the week offers each boy the opportunity to find an area of positive self-expression. This interest may then be used by the educateur to help the maladjusted child enter more fully into age-appropriate behavior. But this is not achieved through planned intervention in the child’s life process, but rather by the physical and emotional involvement the educateur achieves with the child in the various activities.

In France, the educateurs work in and frequently manage institutions for delinquents, retarded, physically handicapped, socially and emotionally disturbed, the homeless, the neglected, unwed mothers, and several other agency settings. They also are trained to function as street workers in slum areas, usually working out of a youth club as a central base."


Why child care work lacks definition
As we have said earlier, the evolution of children’s institutions has put a premium on medical model residential treatment because of the availability of established clinical professions for lending the credibility which was desired. However, perhaps by design or default, some institutions have used family models (the child care worker as super parent) or decided that they would enrich custodial care through the addition of caseworkers, clinical consultants, groupworkers and specialists in recreation, art, group therapy and special education. These people have progressively been added around the living situation in both kinds of facilities. However, the living situation continued to be staffed by non-specialists, and care, originally the function, began to be last in specialization. Care, less sophisticated than other tasks, began to be identified only as a supportive function and its personnel came to be called simply "child care workers". In an article From Slogans to Concepts: A Basis for Change in Child Care Work published in Child Care Quarterly – an American Journal of Child Care practice edited by Jerome Beker who was with you here in South Africa at your last Biennial Conference – my colleague Sam Kelman, now Director of Bellefaire Jewish Children’s Bureau in Cleveland, Ohio and I discussed this overriding issue. I quote from that article:

"The workers responsible for the daily living of children in either of these models are not perceived to have any particular expertise. Living is a non-dynamic activity. So the ‘quantity’ hours are spent here. Other, specifically trained, disciplines have the ‘quality’ hours with the children. Children must separate those specialized moments of help from their regular supervised life experience. They are required to take different pieces of their problems to specialists concentrating on that piece. Care workers, often directed by specialists and administrators, are required to require that of the children.

We have recognized that not all children can be successfully treated on an outpatient basis. Throughout the world, parents and children encounter personal and intrafamilial difficulties that can upset the emotional balance of the family. These difficulties seriously diminish the nurturing ability of parents or markedly obstruct the growth of children. Both in the United States and abroad, residential programs for care and treatment of the young outside the family unit are used as an available resource when family life is so stressed as to warrant that kind of intervention. The nature of that help, however, when comparing programs shows marked differences. Though we believe in the validity of resident treatment and therapeutically oriented group living, we have not thoughtfully, consciously created concepts for a new methodology for this unique instrument of helping. We have simply applied our existing, developed skills to form a ring of services around an unsophisticated daily living situation. The overriding issue is that we have been going about it in the wrong way. Milieu therapy is not simply bringing a variety of specialists into a place where kids live. It is not simply living where you get treated. In spite of all the specialists who deal with separate phenomena of a child’s life, we do not have therapeutic milieu for children. We can have nothing more than a matrix of professionals until we can clearly perceive a professional role that has the capability of integrating a child’s total experience in residence – his specialized treatment requirements with his normative requirements for social, educational, work, and recreational experiences. This discipline must also be a specialist one, unique, however, in that it makes the general a speciality."

What the definition might be
Given what seems now to be a clear assessment of the problem of definition and given also the interesting alternative approaches utilized in other places, a synthesis on what ought to be seems possible. In my ideal world. the child care worker would be a transdisciplinary human services professional whose task is to advance the development of the personality and the social maturity of the young people with whom he works by means of joint action involving the young person, his total environment and the worker. This joint action is totally shared, concrete and purposeful. Child care work is then a process of continuing involvement with young people for purposes of enhancing their growth and ability to function.

Such a worker would therefore be found in residential settings, community services, schools, even in the young person’s own family. Several elements characterize this professional work uniquely and define it as different from others. The first is its functioning base directly in the clients life space wherever that may be. The second is its means in joint action to produce change in three ways, through psycho-social action enabling the youth to accept himself better; pedagogical action for developing skills and fostering a more productive integration; community and societal action for improving and humanizing the environment. The third element is that the educateur is a generalist. That is his specialization. Professional action is not limited to office, to interviews, or to special hours using reconstructed reality. The professional task is the whole of everyday life, making that into a rehabilitation/reeducation process through simultaneous use of the actual milieu, individual and peer relationships, and coordinating the multitude of resources, professional, vocational and social. Such a worker is a specialized generalist, the key to the re-education process.

How the role would work – what does this kind of child care worker do?

The worker as now defined, is the constant-contact practitioner of the life-space of the individual children and the group. As a generalist, he has many roles to play. He may teach a course, do individual tutoring, lead a learning group or practical group in the school program. He may be a group leader for the weekend activity planning meeting or the facilitator/leader for the intensive peer impact group. He may head up a work project in which the boy is involved in the afternoon, may work with him during the preparation of dinner or have a counselling session with an individual youth out of his role as assigned primary counsellor. He may find himself during the evening playing monopoly with one of his counsel-lees and two other boys, and be on overnight duty seeing that the young people get to bed and get settled for the night.

Any of these specific tasks or activities of the worker reflect his functioning in one of five major areas which comprise his role. These are: individual work, group work, curriculum, physical care and integration.

Individual work
Commencing at intake where it is identified that he is to be the new boy’s primary counsellor, it is the workers task to set up contacts with him that will lead to the development of a therapeutic relationship. To do this, he talks with the youth, gets acquainted with him, discusses his interests and his perception of his problem. These become entry points for beginning to build this important relationship. The worker shows the young person around, re-introduces him to people, helps him settle into his room and directs him into the program during his first days. During this period the worker presents himself and explicitly defines himself as the key resource, the person on whom the youth will depend for helping him to integrate himself into and to use the program.

Next steps are to review the initial contracting through which the youth has been admitted and begin planning specific goals and program avenues for the achievement of these goals. These become anchor points for the continuing one-to-one relationship which will help him to integrate his experience into his development. The therapeutic relationship progresses as the young person begins to perceive his counsellor and the programs as worthy of trust, as having demonstrated interest in him. as being able to tolerate his difficulties. More rapid strides are made as the counsellor shows he has a depth of understanding and the ability to help the youth make connections between his present behaviors or feelings and past experiences. As these are mutually discovered and shared they become reference points which can be employed by the worker in behavior management and in effective limit setting. They become the basis for the development of insight and illustrate the role of the individual counsellor as therapist. Behavioral eruptions, periods of withdrawal, episodes of anger, displays of hostility, moments of dependency will give new entry points to the worker to enrich the content of his work with the youth. These are employed both in life-space immediate interventions which can also be interpretive, or they can be brought into a regularly scheduled personal recognition session held (or not held) depending on the need of the young person, the need of the situation, or whether the development of insight is identified as a goal to be worked toward.

Though the counsellor may well foster a degree of dependency on him for therapeutic purposes, it is equally his task to help his client to use the relationship with him to bridge outward and accept help from all other staff and interventions from other group members. It is a rule, however that it is the youth’s individual counsellor who makes interpretive statements to him as an intervention. All other staff make functional reporting statements. These can be quite direct and powerful but must reflect back to him the nature or impact of this behavior only, and not intrude into the area of making emotional connections or offering historical reasons why. Youth can be specifically referred to their individual counsellors to take up reasons for a particularly troubling piece of behavior or to develop an answer to a question that has a lot of obvious front-end loading to it. It should be a goal of the work to help each group member understand himself and his own dynamics, his own social situation and his own learning capabilities to the highest degree to which he is capable. Helping individual youth to come to those realizations, to set appropriate goals and work on the basis of sensible plans, is one of the identified professional responsibilities of the youthwork professional.

Group Work
The principal vehicle for building the living group into a dynamic tool is the actual content of the groups experience – school, work program, activities, hikes, camping trips, cooking dinner, getting the firewood, having a party, sports, discussions, mealtimes, group meetings and free times.

The nature of leadership and the effect of peer influences are significant determinants of the style of the group work which apply regardless of the nature of its curriculum. The worker must eschew laissez-faire leadership for he is leader by virtue of his role and his helping responsibility. He must feel complete confidence with this role so he can affirm it when tested and can equally eschew dictatorial leadership as a retreat. The worker must provide democratic leadership. His retreat when tested is to a review of purposes and expectations, to clarification, to limit-setting but never to authoritarianism. His task in leading the group work is to develop among the members a shared responsibility for the group’s process, activity and its value to its individual members.

His success with this will be reflected in the quality of peer influence he facilitates. Peers will rapidly flow into and fill a void created by laissez-faire leadership. Pecking orders and drill sergeants quickly emerge in situations of dictatorial leadership. Youngsters need each other and can help each other. The determining factor in whether group membership is helpful to an individual in combating feelings of alienation, whether the group can develop feelings of shared problems, issues and tasks, whether it can, in fact, pursue a curriculum of living that has positive benefits to its members, depends largely on the style of leadership, the tone set by the worker and the expectations for the groups interactions with its members, one of whom is the worker. The business of the group, then, is tasks, fun and process – what it does and how it does it. Both are equally important. Reaction formation against the potential threat of tyranny of the group has perhaps held us back from making proper therapeutic use of it. But children live in groups in residential settings. We need to learn to use the power of that group beneficially for the individuals. It must be part of the milieu workers skill to include, as tasks of the group, feelings and process issues as well as planning around constructive ways of living and interesting things to do.

Is the vehicle that it all rides in, group work, individual work, the kids and the workers. It is the scope of curriculum what the group is doing. It is getting up and going to bed and all points in between. When the events of the day and sequential contents of days and days are viewed in this way – as curriculum – we change the entire nature of present definitions of child care work in a residential program. The grind of supervising kids ends. We are not supervising kids. We are working with them both individually and as they mesh together in the group or don’t. Control issues vanish and are replaced with content issues, highly relevant pieces of the total curriculum.

An outburst of aggression is not, in the curriculum sense, a threat to the child care worker’s control of the group. It is an important moment for democratic leadership using principles of group work to engage kids in an exciting process of converting acting out to talking-out, learning about anger and its impact and using the dynamic force of the aggression to outline some new program opportunity which the group can then do or work on developing further. But first of all, it’s a matter of view. Aggression is natural. We love it when it is moving along positively producing good ideas or a good baseball game. We don’t need to like it less when it erupts suddenly; that too is natural, though we may use our selves quite differently around one issue or the other. The total concept of curriculum also includes the specific activities in which the group engages. the routine necessary to its civilized living, the regular jobs necessary to its survival and the special projects of work and play which come out of the group work. In its totality it is a laboratory for kids learning which includes both learning, and learning how to learn.

The milieu worker, to develop fully the curriculum of living, must pursue two parallel lines of ideas as a continuum. These we call capitalizing on what happens and designing the environment. In the first, the worker responds to clues, germs of ideas, indications of tension that emerge in conversation, in sounds, through observations of everything from individual moods to the weather. These may indicate need for enriching the curriculum. There may be indications of interest that can be developed through group discussion (e.g. planning a trip to the beach). There may be new entry points discernible for individual work to be done. But everything that happens is a significant part of the curriculum of the groups living and presents to the worker the possibility for capitalizing on it.

In the second dimension the worker purposefully plans specific activities or events to achieve desired goals. A rash of sex talk, for example, is not just simply a behavior problem. It probably needs limits set on it, but it probably also needs a bull session or a film. Itchy, annoying, irritating behavior needs to be elevated into a hike or a chinning contest more than it needs to be squashed so the group can get back to "normal". Normal (usually defined as a state of nothing bad happening, which automatically prevents anything significantly good happening) is not the goal. Neither is the goal of curriculum to have everything be a beautiful success. Rather it is to create a fabric that has interest, fun, new experiences, new ways of solving problems that will help kids to raise their consciousness of what happens, why, what can happen and what they can do about it.
The curriculum of daily living, in this construct, is the singularly most important thing. Group work and individual work emerge out of it. And, it is these very nitty-gritty things which have heretofore been construed to be non-professional and consigned to the back room of management or supervision and viewed as non-dynamic that are now the principal arena for professional work with kids.

Physical Care
Not usually perceived as a responsibility of professional people, physical care, both of young people and the unit, cottage, home, ward, dormitory that they inhabit, are particular and emphasized responsibilities. There is no other professional focussed in such a way as to assume these responsibilities, nor is any professional able to use the experience gained in this area for advancing the progress and goals of group performance, individual security and growth.

Actualizing a concern for physical welfare can provide significant entry points into feelings. anxieties, ideations. Being involved directly with a young person in issues of personal hygiene, sexuality, body image feelings, provides opportunity for intensive relationship building, life-space counselling and on-the-spot education that is available to no other therapist. Frequently looked on as an onerous chore, these responsibilities when viewed in this way, take on a valence that enriches and intensifies the work while meeting basic human needs of young people that are critically important to be met in quality ways.

The worker who is attuned to the realities of structuring the environment and caring for the physical space which his group utilizes, is provided a vehicle for building feelings of ownership on the part of individuals and group which contribute directly to the enhancement of self-esteem and to the reduction of alienation. In addition to all the values of living in a well-cared for physical setting, the learning opportunities available to young people when workers provide quality role models in the use of shared facilities are direct and multi-dimensional. Problems in managing the unit become elements of curriculum for the group. Problems in a youth’s managing his own body become ingredients of individual curriculum whether that is nutrition, alcohol, drug or physical abuse, or establishing a regimen of weight lifting to become a healthier, handsomer specimen. As such, the physical care of individual and the environment are both the responsibility and the opportunity of the youthworker.

Integrative tasks for the worker occur along three avenues. When he is functioning as group leader it is his task to integrate each youth member into the totality of the group. Here he must define clearly, or get the members to define, the purpose of the group’s activity and get them working on it. Group work is a process and the youthworker is in complete charge of the process. In this way he doesn’t need to he in charge of the people; they can be in charge of themselves in relation to the task at hand. Part of being in charge of the process is having an eye to the fringes so that drifting attention can be continuously fed back to involvement in the group’s activity.

When the youthworker is functioning as individual counsellor he is the integrator of each of his counsellees total experience in the program and is the bridge from the past to the future. In the fragmented design of the departmentalized treatment facility this important task has always suffered neglect. The child, sent from specialist to specialist, is alone at the center of his experience. A skilled milieu worker however, who inhabits this center with the child, can engage with him directly in the important process of synthesizing his continuum of experiences, extracting meaning and integrating new learnings, both intellectual and emotional, into new patterns of functioning.

Finally, the milieu worker integrates the wide range of outside skills into the on-going process of individuals; the group’s and his own professional needs. The fact that this breed of worker is a competent professional does not suggest that he is also a psychologist, a psychiatrist, a nurse, a special educator, a doctor. He is none of these and needs them all. But rather than being "on the team", he is chairman of it. The worker must determine when his knowledge of the youngster is insufficient and then seek information from the psychologist and consultation from the psychiatrist. He must know when his program resources need the enrichment of outside resources and procure them. The range of resources needed by the skilled milieu worker is rather more because of his ability than less. His needs will extend over a range of specialists from a psychiatrist to help him formulate his own diagnostic understanding of a youngster all the way to a geologist to meet with the group in advance of a hike. Each specialist resource person has his unique contribution to make to the life of the group. The worker must know each special value and orchestrate the whole.

Throughout the different facets of the youthworkers practice whether in individual work, group work, the nature of leadership, his management of the ever-evolving curriculum and processes of interaction, the principal stock in trade that the worker has – his principal helping quality – is the purposefulness of his role and relationships. It is after all not the worker’s personal affinity with youth, his parent-like functioning or his peerness that is at the center of this whole thing. It is his clarity as a professional who has a specific role in the life of the child and in that child’s ecological system.

This definition of the child care professional has additional advantages. It defines a range of responsibilities that, for the benefit of young people, must be carried by one or more helping persons. In earlier models, these responsibilities were divided. but those models featured fragmentation. This model is an integrative one and allows the child to make a strong investment in a competent individual who can help him along, when he’s with his group, when he’s engaging in program and when he’s in need of care.

Additionally, though ideally suited to progressive residential settings, it is not limited to them. This is the professional needed for group homes, for day treatment, for community based programs – for any program where a young person in need of service will be receiving that service in a context of social interaction and environmental involvement. The transdisciplinary child care worker is the one professional that kids need across the wide range of available service. He’s the one worker whose speciality is the broad spectrum of kids growth needs. And he is the orchestrator of the rest of the specialist disciplines.

This paper was delivered at the Fourth Biennial National Conference of South Africa’s National Association of Child Care Workers (NACCW) in Cape Town. At the time Herb Barnes was Director of the International Learning Exchange in Professional Youthwork (ILEX), President of Youthorizons, Inc., and Adjunct Assistant Professor at the University of Minnesota, USA.

Reprinted from The Child Care Worker, Vol.3 No.2 February 1985, pages 6-12

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