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Selected Readarounds in Child and Youth Care

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The Milieu Staff

Ralph D. Rabinovitch

As expected, staff roles, responsibilities, rewards and related issues were recurring discussions ...

"After all, we’re only people"

Redl took it for granted, like everyone else, that "the most important aspect of a milieu is staff" and that many virtues in workers are desirable, including integrity, maturity, self-discipline and flexibility. He called the primacy of staff self-evident and, having mentioned the obvious, he rarely referred to it again. He hated cliches and avoided them. He did, however, give much attention to the questions of staff recruitment, selection and training. He always hoped for the ideal and expected the best. At the same time he recognized inevitable limitations; a major source of his profound influence with front-line workers was his respect for them as they were, with the prospect of continuing growth always implied.

"Let’s all bail together, or else"

The theme was the need for every worker to identify, beyond his or her individual discipline or points of view, with the total program. Either we keep the boat afloat together or we all sink together. This issue was especially crucial in a setting like ours with a very large staff drawn from at least eight disciplines. It was not always easy to maintain identification with the total effort but Redl kept the issue in the air and deftly brought us back to it.

"Prima donna – so long"

A specific related situation that especially intrigued Redl was the relationship of the individual therapists (psychiatrists, psychologists, and social workers in our setting) to the milieu program. He spotted with an eagle (and jaundiced) eye the therapists who viewed the milieu as an interfering ancillary, and they picked up the message loud and clear. Unreasonable territorial issues, rivalries, conflicting goals were often handled in the seminars with humor, directed not at the person but at the situation – a rare skill that was part of Redl’s teaching genius.

"The staff, their attitudes and feelings – but please let’s not call it all ‘transference"’

In the field in general it was customary to spend hours in at times racking discussions of workers’ feelings; these topics were often raised in RedI’s seminars. He acknowledged their importance and listened patiently for a while but before long managed to channel the discussion to issues of child management. Feelings are always present but a major challenge for the worker is to separate feelings from action, "two very different items on the milieu menu."

"Behavior received in a day’s time"

The impact of action or specific management is the focus here. There is a constant need to define the "forms" employed by staff for intervention – "limit-setting, expression of acceptance and love, etc.," – the actual communications to the child. Sensitivity to these forms is crucial for staff role awareness and monitoring. There is often a conflict between feeling and form. An interesting example arose from time to time in the overuse of snacks in the living areas. During these binges, wishing to provide compensatory gratification, everyone seemed to ply nourishment day and night. There was no question that many of the children at Hawthorn, previously deprived, needed compensatory gratification at many levels. But when gratification becomes seduction, a pause to examine the form of intervention is in order. Here the feeling, the wish to gratify, is positive; the form is negative. As Redl reminded us, pacifiers are usually at best only transiently effective.

Rabinovitch, R. D. (1991) The Milieu Staff. In William C. Morse, Crisis Intervention in Residential Treatment, The Clinical Innovations of Fritz Redl. New York: Haworth Press. pp 76-78

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