Working with Children and Adolescents in Residential Care

A Strengths-Based Approach

Bob Bertolino

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317517290
• Edition: 1
• Topic: Psychologie
• Subtopic: Psychologie du développement

Working with Children and Adolescents in Residential Care: A Strengths-Based Approach is written for professionals who work with children and youth in out of home placements, be they social services workers, child welfare or family court workers, educators, or mental health professionals in general. The book offers an approach that professionals can use to positively impact the lives of young people in residential facilities. The book emphasizes the strengths and abilities of young people from the assessment phase of treatment through discharge, and helps readers to take into account the views and actions of youth in order to provide clients appropriate services. This new volume includes sections on principles of effective youth care work, personal philosophy, positive youth development, teamwork, staffings, and crisis management.

1
A Day in the Life

The Many Faces of Residential Youth Care Workers

What first interested you in the field of Youth and Family Services (YFS)? What about residential care, specifically? I have over the years heard many intriguing stories about how people became affiliated with YFS. I too have a story, one that begins with a job as a resident counselor in an emergency shelter for displaced, troubled, and homeless youth. It’s a job that I almost did not get.

In 1989 I spotted an ad for employment at an agency by the name of Youth In Need. Not only did I have any idea what a resident counselor was, but the only thing I knew about Youth In Need was that it was a nonprofit—at least that’s what the ad said. I knew about nonprofits since I was working on an undergraduate degree in social work. I also played nightclubs in bands that barely made enough to survive—which, by my definition, made us nonprofits.

I applied and to my surprise was offered an interview. It was on a Monday at the agency’s emergency shelter, which aside from signage out front with the name “Youth In Need” looked like the other houses around it. I was as unprepared as one could be. I wondered: What do they do here? What might I be asked to do if hired? What if I blow it? The longer I waited, the more unanswerable questions populated my imagination.

As I sat nervously in the foyer, I heard a sound that was out of context. It was a guitar. Not from a song on a nearby radio, but rather from a guitar being played somewhere in the “house.” The sound was faint, leading me to think I was hearing things. But there was a distinguishing characteristic of the sound that let me know it was quite real—the guitar was very out of tune.

Being a marginal musician didn’t get in the way of my living and breathing music. No matter how out of tune the guitar, I had to find the source. In a music-induced trance, I followed the warbly twang down a narrow hallway, arriving at a set of double doors. Peering in, I saw what resembled a family room—a hangout of sorts—a place to chat, read, maybe watch TV. The room was plain, with flat white walls and a few sparse furnishings. The decorations resembled those of just about any physician’s office waiting room.

What made the room unique was the source of the “music”—a young man with a glossy red Fender Stratocaster knockoff. The youth sat on a couch, fully immersed in playing his unplugged electric guitar. Dressed in jeans and a long black overcoat—not unlike the one I had on—he strummed away before noticing me and rising from the couch. Because I had not thought things out, I was startled when the youth spotted me. I briefly considered running for the door but offered instead to tune his guitar. His response was an exuberant yes.

I soon learned that his name was Adam and that he was 15 years old. It was clear from the get-go that music was a big part of Adam’s life. I knew little more than his name before he began listing his favorite bands and songs. He seemed to have an encyclopedic knowledge of current music. While Adam’s voice conveyed his excitement about music, it was his eyes that revealed his passion.

The conversation unfolded quickly. Adam told me he was away from home because of problems with his dad. The more he spoke the more I began to understand what brought kids to Youth In Need. Although my perception of the agency was just starting to evolve, it was clear to me that youth like Adam were experiencing dire circumstances. I was transfixed by what Adam had to say. I may have been drawn to the room by the sound of his guitar, but it was his story and the melodies that made up his life that enveloped me.

It was a matter of time before Adam got around to asking questions of me. It turned out he only had one. He asked, “What is your job here?” Just as I was about to tell him I was there for an interview, a woman entered the room. “There you are!” she yelped. The woman was the shelter director, Laura. She had gone to the front foyer to get me for the interview only to find me playing guitar with Adam. I was embarrassed but tried to remain calm as I wished Adam well and headed with Laura to the interview.

My questions about Youth In Need, which I learned was called “YIN,” were answered during the interview. I learned that the building we were in, “The Shelter,” was the focal point of the agency, started as an alternative for displaced children and youth. The pieces of the puzzle came together quickly, and it all made sense.

I made it through the interview, relying mostly on what I had gleaned from school and, well, life experience. As I left Youth In Need, I walked down the same hallway that had led me to Adam. I wondered what would become of him.

Over the next few days, I thought about the entire experience at Youth In Need again and again. I realized I shouldn’t have wandered down the hallway and gone into the room where Adam was. I wasn’t an employee. I didn’t have permission. But at the time, those thoughts had not crossed my mind. What I saw was Adam the person—not Adam who was in a home for kids. Naïve as it may be, I saw him no differently than someone I would encounter on the street. I met a person who like me enjoyed music, someone I could do something nice for, like tune his guitar. I had to leave it at that.

I got the job.

Sometime later, Laura told me why I had been hired as a resident counselor. It wasn’t because of how I answered the interview questions—which was unremarkable—or my level of professional experience—which was zero—or anything seemingly relevant to the interview. It was because of what she witnessed in those brief moments between Adam and me. She saw something in me that let her know I would be a good choice for the job and was worth taking a chance on. What others might have considered drawbacks to hiring me, Laura saw as strengths.

It has been more than 20 years since that interview. I have had many different positions at Youth In Need, and while I also hold a university faculty position, I still work at the same agency. What about you? What’s your story? I invite you to take a moment to reflect on the following questions:

• What compelled me to start working in YFS?
• What do I now find most compelling about YFS?
• How do I cope with the uncertainties that accompany my role?
• What do I do to embrace the role of youth care worker (YCW), including the ups and downs?
• How do I face the daily challenges of being a YCW?
• What do I do or tell myself when things don’t go as planned? [e.g., with a particular youth, on a shift or interaction, etc.]
• What do I need to be a successful YCW?
• What keeps me in YFS (and as a YCW)?
• How can I have the greatest impact in my role?
• How can my work be even more meaningful?
• What can I do to continue to challenge myself and improve my skills over the course of my career?

Beyond what initially drew you to YFS, what keeps you there? And if you work in a residential program, what is it about your everyday work that fuels your passion? It can be helpful to revisit these questions from time to time. You are encouraged to also consider what you already do to meet the challenges of being a RYCW and what you will need in the future to grow as your career evolves. You are important, and we need you. This book is for you.

Here, There, and Everywhere: Profiling the Residential Youth Care Worker

As described in the preface, youth in out-of-home placements, be they short- or long-term, are served in a variety of settings, including emergency and runaway shelters, residential treatment and group home facilities, inpatient psychiatric units, intensive outpatient and partial day treatment options (e.g., substance abuse or eating disorder clinics), juvenile and other corrections facilities, and independent and transitional living programs. Typically, residential programs house anywhere from a handful (such as emergency or crisis care shelters when census is low) to several dozen youth (as with large state-run institutions). Residential facilities vary in terms of youth served including age ranges, gender, length of stay, and, in some cases, demographic areas served. For example, some will only take youth in the custody of the state while others will also accept private placements. In addition, out-of-home placements can be very generalized or specific in terms of the type of services offered. Programs may focus exclusively on substance abuse rehabilitation or youth who have histories of violent behavior, for example.

A common thread in each of the settings listed are residential youth care workers. Depending on the program, RYCWs are sometimes referred to as resident or youth counselors, psychiatric technicians (psych techs), child or youth care workers, or house parents or managers. RYCWs are not only necessary to the everyday operations of residential facilities, they are arguably the most important form of personnel. It’s very simple: Without RYCWs there would not be residential programs.

It was once believed that the “important” therapeutic work in residential facilities was provided by clinical staff composed of counselors, social workers, psychologists, psychiatrists, and the like. And although teams are responsible for care in residential programs, at the center of teams are RYCWs. It is RYCWs who spend the most time with youth and, ultimately, have more opportunities than any other professional to positively influence their lives. Although the responsibilities and duties of RYCWs may vary from facility to facility and program to program, there are common elements that run through all of these positions. General duties of RYCWs include the following:

• Providing safety, physical care, supervision, discipline, emotional connection, and educational support to youth (program ratios of staff to youth can vary according to licensing and funding requirements; for example, some program will maintain a ratio of one staff member per six youth);
• Completing and /or overseeing daily program tasks and functions;
• Conducting face-to-face or telephonic screenings and /or intake interviews (assessments);
• Meeting formally or informally with youth;
• Leading educational, support, and /or treatment groups;
• Managing crises with youth and in programs;
• Participating in the physical upkeep of facilities; and,
• Working as part of a team that may include other mental health and social service workers, health professionals, educators, and recreational specialists (Bertolino, 2014).

The responsibilities of RYCWs do not end with formal job descriptions. Instead, most RYCWs are familiar with the phrase, “Other duties as assigned.” RYCWs are in effect the “go-to” persons—preserving the safety and well-being of youth while juggling multiple on-shift tasks. On a given shift a RYCW could be supervising several “residents,” working to resolve a conflict between two youth, and monitoring a crisis call line, with documentation awaiting. RYCWs not only have numerous responsibilities, but they carry out those responsibilities in environments that are fast-paced and require conscientious, on-the-spot decision making.

Like nurses or emergency room residents in training, RYCWs accept that shifts may long and include overnights. Some overnights are “sleep shifts” in which a staff member sleeps but may be awakened if a crisis arises. A benefit of residential programs is that RYCWs can often arrange to work shifts that accommodate school or other work schedules.

The are many dualities involved with the role of the RYCW, the most fundamental of which is serving both in a therapeutic capacity and a position of authority. In one moment a RYCW might help calm a youth with suicidal thoughts who is having a panic attack. Later in the shift, the same staff person might give the consequence of a level drop to the very youth who was panicking earlier in the day. Over time RYCWs learn to negotiate such dualities day to day, shift by shift, and interaction by interaction. The RYCW is everything to everyone when it comes to outof-home placement.

But there is another, much more pervasive duality that lingers within the psyche of the RYCW that can, at minimum, whittle away at the faith of RYCWs and, if left unchecked, spell the end of careers. RYCWs, like many in mental health and social services, choose to help the most vulnerable. Study after study supports the need of prevention and intervention services to children, youth, and families. These studies are backed by public sentiment that largely reflects a societal value placed on caring for those who are unable to care for themselves. Herein is the duality for the RYCW. Despite the value placed on caring for our young, the first funding cuts are often made are to mental health and social services. And as the saying goes, “No money, no mission.” Even the most committed RYCW experiences disappointment arising from the hypocrisy of providing services that society states it values but, in the end, does not want to fund. That equation proves to be too much for many.

Other threats to longevity of RYCWs include long hours, unrelenting job responsibilities, and low salaries. Without awareness, guidance, and support, the role of the RYCW can seem too much. Let’s add it up. First is the emotional distress on providers who are doing the work in the name of helping others. Next is the effect of staff turnover on the quality of care to youth. The pool of qualified individuals willing to work for high stress and low pay has dwindled substantially over the past two decades. RYCW positions used to be appealing to persons who had just completed their bachelor’s degree and /or were perhaps pursuing a master’s. Not any longer. When fast food restaurants pay more than the average agency residential program, there is a problem.

The impact? Turnover rates with frontline staff, particularly those in residential setting, average between 22%–60% annually, with some agencies having as much as 75% of their staff with less than 1 year of experience (Barford & Whelton, 2010; Hwang & Hopkins, 2012; Proyouthwork America, 2011; Wilson, 2009). To hire and train each new staff member costs between $7,000 to $12,000. So if you are a RYCW and are beyond 1 year of service, you have surpassed the odds of attrition. And if your organization has an annual turnover rate among frontline staff at or below 20%, you are accomplishing something extraordinary.

Now for the good news. There are many who understand and support quality mental health and social services for youth and families. In addition, please know how valuable you and your efforts are. There is nothing more important than giving of ourselves. The first purpose of this book is to help you stay connected with what inspired you to go into YFS to being with. Inspiration is both healing and contagious. The second purpose is to provide ways of building on the knowledge and ability you already possess so that your work can be even more beneficial to youth and families.

The Long and Winding Road: An Evolving Perspective for Residential Youth Care Workers

History reveals that most residential programs were founded on principles associated with the medical model—focusing on deficit and pathology. The prevailing theory was that at minimum there was something wrong with youth (e.g., they were unable, incapable, or unwilling to change their behavior and /or cope; they could not overcome debilitating family problems or traumas; they lacked skills, etc.) and, at worst, youth were in some way “damaged.” Michael Durrant (1993) stated, “Much residential work has reflected these ideas of children being damaged or disturbed, children processing some problem or pathology, or parents being incompetent or deficient” (p. 12). According to this perspective, the core questions has been, “What’s wrong with youth?” The implications of such a question are far reaching. Durrant continues:

If we approach our task from this viewpoint, inevitably we will see our role as that of experts who operate upon clients in order to fix or cure something. This view may be reflected in providing therapeutic care to help children “get over” damaging experiences, exerting control to modify unacceptable behavior and allow con...