The prevailing cultures and staff dynamics in children's homes: implications for training

This paper is about training, and the learning needs of residential child care staff that training should address. It takes as its starting point research that focused on what happens in children's homes, as described by residential staff themselves. It depicts the tasks which staff carry out in relation to their overall goal of benefiting the children and young people in their care, and considers the ways in which staff work to develop and maintain viable and effective teams. Distinctive cultures emerge when working in staff teams, and the paper shows how these are related to the kinds of practice that can be achieved in residential settings. The knowledge base, practice skills, and personal qualities required to work within residential child care are detailed. The paper closes by addressing the implications which this research has for training residential staff to work effectively in group settings. It argues that fundamental to training competent residential staff is a commitment to developing an ongoing culture of learning in workplace settings.     

Transfer of learning: concept and process

This article will present findings from a doctoral study exploring the impact of 'SVQ Care: Promoting Independence (level III)' within children's homes. The study focuses on the extent to which SVQs enhance practice and their function within a 'learning society'. A total of 30 staff were selected from seven children's homes in two different local authority social work departments in Scotland. Each member of staff was interviewed on four separate occasions over a period of 9 months. Interviews were structured using a combination of repertory grids and questions. Particular focus was given to the assessment process, the extent to which SVQs enhance practice and the learning experiences of staff. The findings suggest that there are considerable deficiencies both in terms of the SVQ format and the way in which children's homes are structured for the assessment of competence. Rather than address the history of failure within residential care, it appears that SVQs have enabled the status quo to be maintained whilst creating an 'illusion' of change within a learning society.     

A Survey of Problematic Sexualized Behaviors of Children in the New York City Child Welfare System: Estimates of Problem,Impact on Services,and Need for Training

ABSTRACT

Forty-eight of 52 (92%) agencies contracted with the New York City Administration for Children's Services (ACS) responded to a survey about problematic sexualized behaviors (PSB) of children in different levels of care within the child welfare system. Results revealed that almost all agencies reported PSB within their foster boarding home and residential treatment centers. A majority of agencies perceived PSB to be a significant problem for which staff and families were not sufficiently trained. These findings highlight many avenues for advocacy, clinical intervention, and staff development.     

CONSCIOUSLY WORKING AT THE UNCONSCIOUS LEVEL: PSYCHODYNAMIC THEORY IN ACTION IN A TRAINING ENVIRONMENT

The author explores methods of working with residential child care foster care agencies in developing a psychotherapeutic culture. He suggests that such a culture can only be built on the firm foundations of clear organisational boundaries and task, but that such clarity is not sufficient. In addition, senior managers must have an understanding of unconscious processes and how they affect relationships between adults and children and between colleagues within the organisational hierarchy. The process requires a range of possible interventions including organisational consultancy, practice consultancy and staff support, specialist training and explorations of team processes.     

Welfare Status and Child Care as Obstacles to Full-Time Work for Low-Income Mothers

SUMMARY

In this study, we use new data from the Philadelphia Survey of Child Care and Work to expand on previous analyses: we include child care problems as a work obstacle, and we analyze both current welfare recipients and non-welfare “working poor” mothers. Results show that two main obstacles have a large impact on full-time work: poor mental health and child care problems. Net of other factors, mothers with severe child care problems are 22 percent less likely to work full time. Dividing the sample by welfare status, we find a child care problems effect for both groups. Among welfare recipients, the gap in full-time work between those with severe child care problems and those without is 30 percent. Among the working poor, child care problems reduce the chance of full-time work by about 18 percent. Our findings show that improving mothers' child care situation can significantly improve their ability to support their families.     

Challenges of Interdisciplinary Collaboration

Abstract

The realities of the 1990s, which include reduced funding and resources, the public's impatience with bureaucratic rigidity, and the empowerment of families who want timely and appropriate services, have created a favorable climate for collaborative, interdisciplinary practice. Collaborative, family-centered practice models are being promoted by family/child advocates and professionals. Yet child and family services, for the most part, continue to be provided in traditional ways using individual treatment and categorical services. However, federal child mental health funding is supporting community-wide, collaborative practice in twenty-one sites scattered across the United States. One site, in rural northeastern North Carolina, is unique as it includes a graduate-level, interdisciplinary academic component [East Carolina University's (ECU) Social Sciences Training Consortium (SSTC)] to train and support service providers and families, and to prepare master's level graduates to work in such innovative programs. Called PEN-PAL [an acronym for Pitt-Edgecombe-Nash (three NC counties) Public Academic Liaison] this university/interagency collaborative effort works in partnership with families to coordinate public and community services into a seamless system of care for children with severe emotional disturbances. This article is based upon a qualitative study of SSTC faculty members, and it chronicles the successes and difficulties encountered by faculty in the first year of a five-year collaborative process.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

Surprise in Social Work Education

Training is commonly seen as the most viable way of ensuring good quality care in residential homes for elderly people. The literature on training has focused on a shift in emphasis from traditional 'professional' social work training for staff at a senior level to training which is to be provided for junior level staff. To this end, Scottish/National Vocational Qualifications have been introduced which, through workplace assessment of competence, have been proclaimed to be the means by which to raise the status and career prospects of a social care workforce. This article argues that task-based competence is increasingly being seen as relevant for a 'para-professional' social care workforce such as that found in the residential care sector. In the light of this, research was undertaken to establish whether residents preferred 'trained' staff, holding formal qualifications and/or NVQs, to 'untrained' staff with no recognised qualifications. The research concluded that residents want kind, understanding and experienced staff, and when length of time in post was taken into account, the effect of training was negligible. The study concluded that homes need to select staff for their good personal qualities and encourage them to stay. Staff need training that integrates skill with understanding and above all, assessment should reflect this perspective. Moreover, residents need to be involved in the assessment process.     

The duty to care and the need to split

This paper arises out of psychoanalytically oriented consultancy to teams of staff in the helping professions where there is a statutory 'duty to care'. It takes as its premise the seemingly paradoxical hypothesis that workers may need to split off part of their emotional experience in order to preserve their own mental health and provide reliable services to their clients. I argue that while a professional 'duty to care' requires us to be emotionally 'in touch', the demands of our clients together with the demands of the institutional response to the 'duty to care' cause us to split off parts of our awareness. I also argue that provided the splitting does not become extreme we are doing no more or less than the rest of society. In other words, there is a degree of 'normal splitting' which numbs our awareness of danger and destructiveness and seeks to protect us from too much anxiety and pain. Yet if professional workers are charged with the responsibility of assessing risk and acting accordingly for the protection of all concerned they need ways of being 'in touch' (re-integrating the splits) for some or enough of the time. Finally, I will describe ways of being 'in touch', illustrating the difficulty and the pain of re-integrating the splits and some of the insights that can arise out of this work with examples from my consultancy work.     

The utility of the DSM-5 Z-codes for clinical social work diagnosis

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard reference text used by social workers for diagnosing mental disorders. The social work profession has always had an uneasy relationship with the DSM, but for 33 years there was an opportunity to note a client’s psychosocial stressors on Axis IV. With the publication of the DSM-5, however, the multiaxial diagnostic system was abandoned, and many social workers are concerned that this change limits their ability to provide comprehensive diagnoses. The purpose of this article is to consider an expanded use of Z-codes as one way to continue including social work’s psychosocial perspective on human functioning in the diagnostic process.     

REVERSING A SPIRAL OF DEPRIVATION: WORKING TO AMELIORATE THE RELATIONSHIP OF STAFF AND BOYS IN A RESIDENTIAL HOME

This paper discusses the work of a consultation to a staff group at a residential home for adolescent boys. The work discovered that each encounter increased each group's sense of deprivation. This escalation is understood as their relationship being based upon a spiral of deprivation. In this situation the staff's capacity to think in terms of their training in Winnicott's ideas about residential care, and that behaviour has meaning, was lost. By using himself as the container of staff emotional states, through recognising their communications in terms of Bion's concept of normal projective identification, the consultant was better able to understand the nature of the difficulties in the boys' and staff relationship. Hence, the attempt to engage staff through the consultation was successful and their capacity to think was restored. The material discussed shows this development enabled staff to better contain their own and the boys' feelings, thus allowing the spiral to reverse.     

Attitudes of special foster parents and residential staff towards children

This paper compares the attitudes of special foster parents and residential staff towards children in their care. The exercise was carried out as part of a comparative study of care practice in ‘special’ foster homes (accommodating children traditionally considered too old or difficult for fostering) and ordinary community or children's homes. Overall, care practice in the foster homes was significantly more child oriented than in the children's homes. This finding cannot, however, be explained in terms of attitudinal differences between foster parents and staff. Staff attitudes generally appeared more conducive to the provision of child oriented care than those of the foster parents.     

The residential treatment of an abusing family

Abstract

This article discusses the residential treatment of an abusing family in a local authority setting, when the use of short-stay children's homes was changed to provide a preventive service for families in trouble. The Centre has room to admit a family where the child's safety cannot be guaranteed in its own home.

The structure of the treatment programme is described, the partnership of residential and field work staff, the monitoring role provided by residential staff and the importance of supervision, particularly for those closely involved with the family. The role of the NAI Conference is discussed, and the individual functions of its members in relation to the family. The varied methods of working with the family are described, and the family's emotional response is illustrated with the theme of separation.

The article concludes that the family did respond to treatment, and that we have further to go in developing residential work with abusing families at our Centre.     

Quantifying Littered Cigarette Butts to Measure Effectiveness of Smoking Bans to Building Perimeters

Abstract

Objective: The authors estimated the number of violations of a university policy that prohibited smoking within 25 ft of all campus buildings. Participants: The project was conducted by 13 student researchers from the university and a member of the local public health department. Methods: Students quantified cigarette butts that were littered in a 30-day period inside the prohibited smoking area of 7 campus buildings (large residential hall, small residential hall, administrative building, 2 academic buildings, campus cafeteria, and student union). Results: Investigators found a total of 7,861 cigarette butts (large residential hall: 1,198; small residential hall: 344; administrative building: 107; 2 academic buildings: 1,123 and 806; campus cafeteria: 2,651; and student union: 1,632). Conclusions: Findings suggest that there is low compliance with the university's smoking policy. The described project may be repeated by students at other universities as a method to advocate for policy change.     

From group analytic to systems-centered consulting: a comparison of experience

ABSTRACT

This article provides a personal account of experiences of consultation to staff working in residential child care. The paper starts with experiences of receiving consultation while working in a therapeutic community, then of providing consultation to children’s homes, firstly from a group-analytic perspective and subsequently using a systems-centred approach. The author considers the goal of consulting to staff teams who care for traumatised children and draws conclusions about the different approaches regarding which are most likely to achieve the stated goal. Functional subgrouping – the central method of systems-centred approach – is described in action.     

Working with neglected children and their families

Child neglect has proved a particularly difficult area for social work to address. In the first part of the paper a number of reasons for this are discussed. We go on to suggest that chronic child neglect characteristically involves the breakdown or absence of a relationship of care. Therefore, the social work response needs to include a focus on the relationship difficulties between parent and child which manifest as either an unwillingness or inability on the part of the primary carer to offer reliable, adequate care, and on broader relationship difficulties within the family. In arguing for an approach that pays attention to the intra-personal and relational dynamics of neglect, we draw specifically on attachment theory and consider how Ainsworth's (1978) typology of attachment patterns can shed light on parenting styles and patterns of family functioning associated with chronic neglect. We use the concept of the 'internal working model' to develop an understanding of the ways in which family members understand and live out their relationships—with each other and with the worker. We conclude by suggesting that this relational approach requires an ability on the part of the social worker to work both with and within relationships, and look at the contribution that a critically informed relationship-based approach can make to work with families where child neglect occurs.     

Where can I mourn? Psychodynamic contributions to working in residential child care

ABSTRACT

Loss permeates the experience of being placed in residential child care, yet residential workers are rarely trained to work with young people who are grieving the loss of family and home. This article will provide an overview of psychodynamic theories of mourning, and will discuss how grief work can be facilitated for children and youth in residential child care.     

The integration of child care services in Scotland

This paper describes the development of integrated child care services in Scotland with a particular focus on the role of residential child care provision. It discusses changes in Social Work Department policies and the impact this has had on their relationship with the Children's Hearings system. Recent research shows the pattern of use of residential and foster care in three Social Work Departments and issues in the development of residential services are identified. Three particular examples of service integration are described: residential outreach work; a centre for young people under an integrated management; and multi-agency youth strategies. Social work and education services in Scotland are in the process of radical change. In the context of the integration of child care services, the paper discusses the impact of local government reorganisation and changes in child care legislation.     

Residential Child Care Agencies as Learning Organisations: Innovation and Learning from Mistakes

The residential child care sector has been scrutinised via numerous inquiries following revelations of abusive and poor practice. These inquiries have made numerous recommendations which involve changes in practice and organisational culture, much of which is congruent with the features of a learning organisation. This article details research which evaluates the extent to which residential child care agencies exhibit the characteristics of a learning organisation. The research involved qualitative and quantitative methods, drawing on the experiences of a range of staff from the residential child care sector within Scotland. The findings revealed that residential child care agencies exhibit many features of a learning organisation, yet the extent to which these characteristics are perceived to exist differs significantly in line with the position staff occupy. Most significant were the findings that many staff do not feel supported to take risks nor encouraged to develop innovative practice; mistakes are not used as learning opportunities and a culture of blame is felt to exist. The implications of this are significant and this article identifies changes necessary to allow residential child care agencies to operate as learning organisations.