Tuesday, November 18, 2008

1st step, get on the horse. Next step, stay on the horse.

Now that I'm not working at my job anymore, let me talk about my job without breaching my confidentiality agreement.  I am specifically not going into the detail I could, as most or all of my readers are looking for an introduction into the subject, and the less I say the less chance there is that I will incur legal penalties for my writing.

DCF (department of children and families), formerly known as DSS (department of social services), provides custodial care for children from abusive or otherwise dangerous families.  I will hereon refer to DCF as "the agency".

The above mentioned custodial placements are, to provide an incomplete summary: foster homes, group homes, and residential treatment programs.  The agency also solicits adoption for their advocated children.

Residential treatment programs, used for the children with mental health problems and behavioral concerns can be either for those who are repeatedly unable to socialize in a foster/group home environment or who have specifically been brought up on some criminal charges.  Those convicted of crimes are sometimes sent to DYS, the "juvenile justice agency of the Commonwealth of Massachusetts" (prison), in other cases they are sent to secured residential treatment facilities.  Those awaiting trail on a crime for which they have been indicted are most often placed in these secured treatment centers as they cannot (really) yet be committed to DYS and the agency, while retaining custody of them, will not newly submit them for foster care.

Residential treatment programs or, to the kids and direct care workers, simply "programs" provide a structured, scheduled daily lifestyle with therapy services and incentives for good behavior/investment in treatment.  Long term placements also contain schools, where the teachers cater to the various levels of education the residents have achieved.  While the classrooms are small, the teachers are run ragged attempting to address all the different academic issues of the residents.

Being in a residential treatment program means, for the adolescent, twenty-four hour supervision by direct care workers.  These individuals maintain the daily schedule, correct problem behaviors with specific program instituted consequences, assist with the day to day needs of residents, provide feedback, and ensure the safety of residents through searches and sometimes, physical management.

I was fortunate to work in a setting, which I will obviously not name here, that had a long-standing and comprehensively structured discipline system.  All communication was very clear, professional, and when necessary conforming to a powerful and directive language.  Residents that have been moved through multiple programs are usually experienced with physical management, either in observation or through personal experience.  

Every attempt is made to convince residents, and literally put them in a good place, to make good, healthy decisions that will foster their progress through the program and not compromise the safety of themselves, other residents, or staff.  However, for kids who have never known a disciplined, structured environment and who have often been brought up on charges involving the harm of others they sometimes see no other option than to physically act out.  

While physical management is by no means the main job of direct care workers at a program, it is the job on the minds of all staff at all times.  In these settings, the safety of clients is the number one priority, and when a resident becomes a danger to himself or others, it becomes necessary to physically restrain him.

I would like to speak about the tactics and practices involved in management but I believe that doing so would violate my agreement.  I am fairly sure that I can say it is done in such a way as to cause as little harm as humanly possible to the client.  

Moving on.

Treatment programs often have specialties, working with clients who fall into a certain category of mental health issue or criminal offense.  For example, there are programs who will specifically deal with psychotic patients, others who will specialize in dealing with, say, sex offenders.

Working with criminal populations, generally, a main goal is to help the clients/residents develop empathy.  This is an ability that is generally developed during childhood, but, for children who have had to literally fend for themselves, in terms of getting the necessities of survival, other concerns overwhelm this socially necessary development.  Of course, the development of empathy does not prevent criminal behavior, as empathy is just a recognition of the feelings/perceptions of others.  Allowing this recognition to affect one's decisions and actions is what prevents criminality.  So, a final step would be helping the kids become less ego-centric.

With juveniles, especially juvenile delinquents, especially male juvenile delinquents, often anger is the only emotion individuals are comfortable expressing.  Obviously, this is a huge impediment to therapy, and understanding that anger is only a surface sort of symptom of other emotions is crucial to self-awareness, something that many residents almost completely lack.

In my time at work I interacted with individuals who committed some horrendous crimes.  The thing that always struck me about my work was how easy it is to relate to these people even if you are somewhat disgusted by their actions.  It is a reminder of one's humanity and of the instincts that ultimately drive all of us.  I found myself asking at times, was I really that different from this when I was 14?  Different enough to justify these people living in custody and me wandering free?  What more experienced professionals have reminded me is while the feelings and motivations are sometimes the same, the difference is that socialized people have the coping skills and the "conscience", to use a non-industry term, to not act on the occasional destructive urges all people have.

OK.  I'll be back to this.  I've just lost my train of thought is all.

No comments: