Clinical and Residential Services Overview
Several theoretical views of working with young people sustain the work of the Hanrahan Youth Services treatment-oriented residential services organization. The first is system wide and refers to a fundamental view of troubled youth as needing long-term (if possible) or at least extraordinary commitment to them as youth and people. This is easy to express in written form but less easy to apply in the day-to-day world of youth involvement. In practical terms this will be lived out at Hanrahan Youth Services through its commitment to keep working with youth when it appears that they are difficult to serve or difficult to place. This is applied through the willingness of Hanrahan Youth Services to take 'difficult' kids, the willingness of Hanrahan Youth Services to transfer youth from one living setting to another; and the reluctance of the agency to discharge residents. It is felt the PROOF of healthy caring, a dimension universally missing with most troubled youth, is partially shown through tenacity in the face of difficulties. It emulates healthy parental love in its determination and relative performance.
Another universal principle that is applied to youth at Hanrahan Youth Services is a belief that with healthy caring is a need for limit setting as an inevitable part of normalization. While different group homes/foster homes at Hanrahan Youth Services implement this in different ways that are sensitive to gender differences between boys and girls; all foster settings impose normative rules and expectations as an essential part of healthy development. All developmental models of normative growth have implicit elements of development of self-mastery and self-control, and this is incorporated in the Hanrahan Youth Services model of care.
Another universal principle that is fostered is that of accountability and the legitimate need for consequences for inappropriate behaviour. While there is not tolerance for physical punishment as a consequence, naturalistic consequences are viewed as an essential part of normal growth and development for most young people. A related principle is the view that loss of behavioural control has great destructive potential to self and others.
The clinical psychologists at Hanrahan Youth Services provide direct service to the young people in the form of individual psychotherapy. The theoretical underpinnings are eclectic and incorporate psychodynamic, cognitive-behavioural and reality therapy. Most importantly, however is the recognition that the form of the therapy takes into consideration the innate capacity of the youth to develop inner controls, to be able to analyze in an introspective way, and to be able to integrate wisdom with action. The more simplistic the view of the young person is, the more practical and concrete the therapy intervention becomes supportive therapy, and practical skills building replaces insight orientation when needed, and cognitive and behavioural goals are introduced when it is the appropriate strategy of intervention.
“The idea of promoting strength-based practice in residential service agencies often creates an unexpected dilemma. Intuitively, the idea of focusing on the strengths of people is warmly embraced and considered to be a respectful and meaningful starting point in supporting positive change. However, the actual practice of identifying, acknowledging and working with strengths as a starting point for change is rarely experienced by those receiving the service of the community or health care service. Many practitioners from deferent professional backgrounds will claim to be working from a strength’s perspective, it is rare to see practitioners or organizations seriously working from an underlying set of values, principles and philosophy of strength-based practice.
Core Principles of Strength-Based Practice
Researchers and practitioners have developed the following principles that serve as the foundation for guiding and implementing strength-based practice.
1) An absolute belief that every person has potential and it is their unique strengths and capabilities that will determine their evolving story as well as define who they are – not their limitations (not, I will believe when I see – rather, I believe and I will see).
2) What we focus on becomes one’s reality – focus on strength, not labels – seeing challenges as capacity fostering (not something to avoid) creates hope and optimism.
3) The language we use creates our reality – both for the care providers and the children, youth and their families.
4) Belief that change is inevitable – all individuals have the urge to succeed, to explore the world around them and to make themselves useful to others and their communities.
5) Positive change occurs in the context of authentic relationships – people need to know someone cares and will be there unconditionally for them. It is a transactional and facilitating process of supporting change and capacity building – not fixing.
6) Person’s perspective of reality is primarily (their story) – therefore, need to value and start the change process with what is important to the person – not the expert.
7) People have more confidence and comfort to journey to the future (the unknown) when they are invited to start with what they already know.
8) Capacity building is a process and a goal – a life long journey that is dynamic as opposed to static.
9) It is important to value differences and the essential need to collaborate – effective change is a collaborative, inclusive and participatory process – “it takes a village to raise a child”.
A shift to the strength-based paradigm requires careful attention by residential care agencies and care providers to system change processes, evaluation, and appropriate research and best practices. Essential to success with be the collaboration between different community care providers embracing the same philosophy of strength-based practice and development of staff skill sets that enable effective engagement, collaboration, facilitating and mentoring of complex risk children, youth and their families. Community agencies will require long-term and stable funding that allows for targeting of interventions reflecting relationship and capacity building as well as strengthening key processes for resilience that are meaningful to the intended clients and the community they live in. There needs to be a commitment from community agencies to work as co-partners with local schools, parents and other significant community supports to develop informed and evolving effective practice models of nurturing resiliency for high risk children and their families. In doing this, children and their families become more resourceful in dealing with crisis, weathering persistent stresses, and meeting future challenges as opposed to developing dependence on the system.
In summary, a fundamental change to community and mental health practice needs to be based on a set of guiding principles. Guiding principles are not just theoretical. They are about the real attitudes and values that people hold, that shape and influence their way of caring for others at the deepest level of meaning. A true strengths-based approach is one that governs the way we think about people and the way we go about our work on a daily basis for all actions and interactions.”*
* Resiliency Initiatives (2010)
Therefore, some semblance of parenting and coaching of troubled youth is an explicit part of the management style. Individual differences and uniqueness is recognized, but the need for social conformity and socialization skills are also strongly stressed. This is implemented practically with the strong focus on team sports, athleticism, skills training workshops provided by staff on Anger Management, Socialization Skills, etc.