1. Child Care in Practice
Vol. 10, No. 4, October 2004, pp. 345±357
Changing Residential Child Care: A
Systems Approach to Consultation
Training and Development
Johnnie Gibson, Marcella Leonard and Mena Wilson
In this article, the authors describe and illustrate their approach to consultancy,
development and training in residential child care. When working together the authors
form the MOSAIC Consortium and provide training and consultancy to residential child
care services. The article draws on systems theory, systems thinking and the politics of child
welfare to provide an analytic perspective that enables decision-making about the design
of training and development interventions that promote good practice in this service
setting. The theoretical perspective and intervention strategies are illustrated through case
material.
Introduction
This article illustrates and describes the authors' approach to consultancy, training
and development in the context of residential child care. Systems theory (Harrison,
1987), systems thinking (McCaughan & Palmer, 1994) and an understanding of the
politics of residential child care informs the approach (Frost, Mills, & Stein, 1999). We
do not claim that our experience is unique. However, we do argue that while systems
ideas and systems thinking are now long established in the social work literature
(Bruggen & O'Brian, 1987; Anderson & Carter, 1990; Greene & Holden, 1990;
Preston-Shoot & Agass, 1990; Dallos, 1991), the potential growth that could come
from the deliberate use of this approach is rarely realised; one such example is Nunno,
Holden, and Leidy (2003).
The MOSAIC Consortium carried out the work outlined in the article. MOSAIC is a
Johnnie Gibson is an independent social work trainer consultant with Gibson±Cathcart Training Education &
Consultancy he represents the Residential Child Care Project, Cornell University, NY, in Ireland. Marcella
Leonard is an independent social work trainer consultant with specialist knowledge in therapeutic assessment,
childhood trauma and sexuality. Mena Wilson is Director of Unicorn Consultancy, Belfast which provides
training and consultancy to the Care Education and Justice Sectors. When working together these three form
MOSAIC Consortium and offer a systemic consultancy and training service to residential child care.
Correspondence to: Johnnie Gibson, Gibson-Cathcart Training Education & Consultancy, 5 Galloway Point,
Edgewater, Donaghadee BT21 OES, UK. Email: ajg@jongib.freeserve.co.uk
ISSN 1357±5279 print/1476±489X online/04/040345-13 ã 2004 The Child Care in Practice Group
DOI: 10.1080/1357527042000285529
2. 346 J. Gibson et al.
group of three independent professional social workers that bring together their
collective expertise of working in and with residential settings with an aim to promote
quality child care and management practice. The case material in this article draws on
our work with several large and smaller organisations, all of which are providers of
residential childcare.
The article begins with an example of work undertaken by the MOSAIC
Consortium. It then proceeds to outline the knowledge base that informs how we
work and concludes with a framework for mapping and analysing relationships of
in¯uence that can either impede or facilitate good practice in residential child care.
The example that follows con®rmed for us that systems theory, systems thinking and
understanding the politics of care are particularly relevant to understanding and
intervening in this context.
A complex network of relationships that comprises parents, social workers, children
and young people, managers, policy-makers and sometimes the general public
in¯uence each interaction between any child in care and their care workers. Thus,
professional staff and others in the general sphere of residential care who may think
they are background factors are, in fact, very much in the foreground even though not
physically present all of the time. That well known family therapy sound bite that
claims that ``background is fore-ground'' may well be overused but that does not mean
that it is not true. We have found this to be so. We believe the Northern Ireland context
of residential child care serves as a practical example of this idea of ``back-ground and
fore-ground factors''. In the past few years, signi®cant progress regarding improve-
ments in the stock of local children's homes has become evident; the quality of living
environments is improving. This progress relates to the Children Matter plans (Social
Services Inspectorate N Ireland, 1998). Policy-makers and planners who do not
interact on a daily basis with children and young people in residential care deserve
credit for initiating these improvements and for planting the seeds of the differentiated
system of care envisioned in the Children Matter report. We are, however, very
concerned that the emphasis is entirely on ``bricks and mortar''. The total residential
child care service in Northern Ireland is small and would bene®t greatly from a centre
like the Scottish Institute on Residential Child Care. An initiative like this would
provide leadership on practice issues and on specialised training. Our view is that equal
and parallel emphasis needs to be given to practice as well as improvements in ``bricks
and mortar''. Leadership in the area of practice and training is not aspirational. It is
essential, for it is as recent as 2001 that the Northern Ireland Assembly described the
local residential child care service as being ``in a state of crisis'' (Committee for Health
Social Services and Public Safety, 2001). Our point is that the sector needs leadership to
develop a vision that builds on current good evidence-based practice that acknow-
ledges the complexities of service delivery needs more that a bricks and mortar strategy.
A Case Study: Anxiety, Disarray and Crisis
One of us was contacted by a ®eld social worker who said that she was concerned for
her 13-year-old client and for the team of residential childcare staff that looked after
3. Child Care in Practice 347
her. The young person had a history of aggression (i.e. threatening behaviour) and of
violence (i.e. hitting, kicking and otherwise physically attacking staff). The ®eld social
worker was concerned that the staff team were almost at the stage of walking out. This
would have effectively closed at least one of the homes in this agency. At a meeting
between the team and a consultant from MOSAIC that was organised, it was clear that
the whole team was in an acute state of crisis. The phrase ``traumatised and
disempowered'' ®gured heavily in this team's self-description and experience. In
summary, this meeting comprised tears and fears alongside a commitment to change
but without the power to achieve it. Walking out seemed like the only empowering
option left to them. The initial consultation meeting that took place on a weekend
morning prevented the walk-out from becoming reality. This meeting, initiated by the
®eld social worker, had the sanction of agency management; however, no management
representative attended the meeting. Management was in crisis as well and were not
sure about how to provide leadership at this time.
Here is how the staff team summarised their experience.
d Frequent (daily) aggressive outbursts from the children, which involved hitting and
kicking staff as well as using implements such as knives.
d No designated age band for each unit, therefore no proper assessment system for the
appropriate unit for a child.
d Lack of management support following assaults.
d No of®cial method of recording the detail of the assaults, including the action taken
by staff. As a result of this staff do not record the assaults unless they think they are
serious.
d Lack of acknowledgement by management of the impact of continuous
physical, emotional and behavioural attacks on them as individuals and as a staff
group.
d Lack of external counselling available.
d Sense of isolation and victimisation as a staff group.
d Due to the continued crises in the units there is a resignation among staff of their
inability to provide a continuum of care for the young people.
d Some of the children are clearly afraid of being assaulted in the units where they have
been placed for care and protection.
d Structured care plans not carried out.
d No consensus in how to deal with the assaults.
d Staff have to continue working their shift after an assault, which requires continued
contact with the young person.
d Transference of anger, fear and anxiety to the young people, which therefore negates
any therapeutic work being undertaken.
d Individual supervision does not happen.
d Staff feel undervalued in respect of their experience.
This staff team was clear about their needs. They listed these as follows.
d Team buildingÐthey identi®ed this as a ®rst step.
4. 348 J. Gibson et al.
d Training in Therapeutic Crisis Intervention (Holden, Mooney, & Budlong, 2001)
including safe holding/physical restraint.
d Training in childhood trauma, emotional, physical and sexual abuse and neglect.
d Report writing, recording, critical incident reporting.
d Supervision.
d Therapeutic skills.
d Understanding and responding to self-harm.
d Responding to disclosures of abuse.
d Loss and bereavement.
d Understanding Post Traumatic Stress Disorder.
d Impact of living with trauma on staff.
In her debrief to her colleagues the consultant involved in the aforementioned meeting
reviewed the experience as follows:
I felt frustrated for them, their emotional pain was palpable and so was their anxiety.
There were tears. They care for vulnerable young people yet they are at risk from these
young people, the young people exploit the vulnerabilities of the staff. These staff are
emotionally ``frozen'' and because of their own work based trauma they cannot be alert to
the trauma that the children bring with them. The current situation is that the
traumatized are caring for the traumatized. They feel like they are ``banging their head
against a brick wall'' with management and are about to resort to extreme measures like
walking out, yet their value base of care keeps them there. My strongest feeling on leaving
them was of impending tragedy in a situation that was unsafe for everyone if a
coordinated response does not follow soon.
It would have been easy to be completely panicked by this experience both through
direct encounter and by hearing it described by the consultant during de-brief. The
systemic perspective shared by the MOSAIC consultants helped in three ways. First it
ensured that the consultants did not become overwhelmed by the raw emotion of the
situation. It also helped the consultants to remain ``neutral'' and not take sides and,
®nally, it provided a framework that enabled the design of a suitable intervention
strategy. The following section of the article outlines the consultants' shared
perspective that helped to make sense of these phenomena
Making Sense of Residential Childcare: The Politics of Care, Systems Theory
and Systems Thinking
Residential care in general and childcare in particular has a long and powerful history.
This backdrop casts long shadows and shapes perceptions and attitudes about the
service. Parker (1988) points out that residential child care is very much connected to
its poor-law roots and that there remains a ``persistent public image of institutional
care as `repugnant' '' (p. 8). In the same publication Parker refers to this long-standing
negative attitude that spans past and present as a ``historical continuity'' (1988, p. 8).
Frost et al. (1999) subject residential care to a rigorous historical and sociological
analysis and conclude that a number of key themes are woven into the fabric and
5. Child Care in Practice 349
history of residential care that make it a political activity. The themes that they identify
areas follows.
d The operation of and exercise of power. For example, the power to remove children
from their families and to regulate their behaviour within the system and setting.
d The relationship between the care system and the wider social and political themes
of the dayÐto understand the care system, it is essential to relate its functions,
purpose and operations to wider societal issues such as social class, gender, disability
and ethnicity.
d Tensions between ``care'', ``control'' and ``resistance'' are always present within any
care setting but how these are played out will vary uniquely to each setting.
Subtle and not so subtle comments and observations reveal perceptions and views of
``institutional'' child care. Norman Warner (1992) reports a senior manager who
commented in evidence to the Warner Committee that ``residential child care is a
necessary evil'', not that it is a ``positive choice'' (Wagner, 1990) selected by many
young people as a preference to living at home or in foster care (Frost et al., 1999). In a
similar vein, a now retired Chief Executive of one of Northern Ireland's Health and
Social Services Trusts said on viewing a soon to be opened new build residential
facility for troubled teenagers, ``It's far too good for them''! Ten years after Parker's
(1988) analysis, Frost et al. (1999, p. 1) suggested that the public image of residential
child care has changed little. They report a crisis of con®dence in residential childcare
and that the public view of children's homes is that they are places where children are
``¼ victims, being sexually or physically abused, or villains, who are beyond control,
involved in prostitution, crime or going missing'' (Frost et al., 1999, p. 1).
With the exercise of power comes the risk of dis-empowerment. Children and
young people who enter the care system may be dis-empowered already. Typically,
they have been let down and neglected or abused emotionally and sexually by family
and community, they may have had multiple placements in foster care, and they may
have experienced societal intolerance about their unique characteristics such as
disability or their life circumstances such as being in care. They will certainly be young
people who are both ``innately and structurally vulnerable'' (Goldson, 2002, p. 153);
the former concept refers to characteristics of the individual and the speci®cs of their
immediate family and social environment, the latter refers to societal structures such
as unemployment and poverty. Thus, a pre-requisite to a real understanding of
residential child care is a broad perspective that sees this substitute to family care in the
context of a temporal, social, political and economic climate. And that, secondly,
frames the core tasks of care as being about achieving a balance between empowering
the dis-empowered alongside providing for them and, with them, ``good experiences
of comfort, care and control'' (Winnicott, 1971, p. 31). As we have already seen early in
this article, it is not just the ``looked after'' who know and experience dis-
empowerment, care staff and managers can equally end up not knowing what to do,
where to turn or contemplating extreme actions in order to exercise power and self-
control. At the conclusion of their sociological and historical analysis of residential
6. 350 J. Gibson et al.
child care, Frost et al. (1999) rightly argue and illustrate that good practice in this
arena of social work practice requires a philosophical and practical orientation that
works toward empowering carers as well as the cared for. We agree.
It is to systems theory and systems thinking that we turn now as the ®nal
component of the theory base that helps us as consultants specialising in residential
child care to make sense of what we sometimes observe and feel. The term ``system'' is
widely used in everyday language. When ®rst introduced into the social sciences it was
part of ``general systems theory''. The concept of system has been adopted by many
disciplines (e.g. engineering, psychology, anthropology and biology) (Richardson,
2003). In application, it conveys the idea of a ``complex of elements or components
directly or indirectly related ¼ each component is related to at least some others in a
more or less stable way within a particular period of time'' (Anderson & Carter, 1990,
p. 3). Thus systems theory holds that any organised human enterpriseÐfor example,
schools, businesses, leisure centres, families, and so onÐare comprised of a number of
parts or subsystem. Understanding any part of the system requires knowledge of the
whole as well as how the parts of the system interact, connect or, as the case may be,
fail to connect and exercise reciprocal in¯uence upon each other. Understanding any
subsystem requires knowledge of how the smaller parts ®t into the larger system. Every
system and subsystem has and needs to have boundaries that distinguish it as unique
and that help to make its tasks and processes clear, manageable and achievable.
Systems theory provides a range of analytic concepts that can help to inform,
understand, map and diagnose function, dysfunction and inter-relationships in
organisations, groups (Harrison, 1987) as well as in families (Nichols & Schwartz,
1991). But systems thinking involves more than drafting informative and essential
diagrams and charts. Systems thinking has been described by Senge, Kleiner, Roberts,
Ross, and Smith (1999, p. 6) as ``a way of thinking about and a language for describing
and understanding the forces and interrelationships that shape the behaviour of
systems''. Central among the analytic concepts in systems theory is the concept of
``structure''. To some people structure equates with the organisational chart or the
agreed or required arrangements for carrying out work. In systems theory, and central
to systems thinking, is the idea that structure ``is the pattern of interrelationships
among key component of the system. That might include hierarchy and process ¯ows,
but it also includes attitudes and perceptions, the quality of products, the ways in
which decisions are made, and hundreds of other factors'' (Senge et al., 1999, p. 90).
Thus, ``structure'' has a major and reciprocal in¯uence on behaviour.
Systems thinking requires the ability to see both the ``wood and the trees'' at the
same moment, or another way of saying this is that systems thinking requires the
ability to view system events through a close-up lens and through a wide-angle lens
simultaneously. In application, this means the ability to understand the aggressive
behaviour of the 13-year-old girl described earlier while at the same time,
understanding team dynamics. And at the same time understanding how the
``structure'' affects and is affected by the team and how the ``structure'' affects and is
affected by the wider organisation, and how all of these impact upon the 13-year-old
girl and how the 13-year-old girl impacts upon ¼ and so on.
7. Child Care in Practice 351
In addition to the aforementioned we found Richardson's (2003, pp. 104±112)
framework of systemic biases helpful. These are now listed, and we expand them to
show how we understand these.
1. First bias. When people act, they are normally tying to do something good. This
perspective is referred to as ``positive connotation''. Seeing the positive in another's
actions is better than being critical and judgemental, and adds momentum rather
than resistance to change efforts.
2. Second bias. The observer is in the observed. Richardson (2003, p. 106) points out
that ``one of the effects of holding this bias is that it helps us not to assume that we
can fully know another and to treat our perspectives as partial truths or stories
which in turn leaves room for other truths and perspectives to emerge''. We take
from her work that once we engage with a system, we become part of a new even if
temporary system and that our own actions and inactions are part of this new and
forming reality.
3. Third bias. The only person you can change is yourself. When we try too hard to
change another person or system, our efforts can lead to resistance. Richardson
(2003, p. 107) tantalisingly asserts that ``if you want to create change you have to
sometimes stop being on the side of change''. As consultants we have learned not to
push or persuade; rather, our mental posture is one of curiosity and helping the
change process by helping people to think through the implications of the status
quo, which, sometimes as the example at the start of this article illustrates, can be
chaos and crisis.
4. Fourth bias. When working with one part of a system hold the other parts in mind.
Our approach to this work has con®rmed for us that it is essential to expand
continually the context beyond the initial point of entry into the system until there
is a real sense that all signi®cant actors in the systems are within the frame of
reference. It is not essential for them all to meet at the same timeÐbut as
consultants it is essential that we have contact with all systems elements and that
each in turn knows and understands that our work together is in this systems
context.
5. Fifth bias. Be irreverent. Essentially, this is to do with challenging assumptions and
beliefs, our own as much as others. It might mean with respectful curiosity asking
another person, maybe a care worker or a manager, ``what would be the result if
you stopped believing that a particular child is violent''. We have seen this several
times in relation to children described as violent. Certainly, they can be
intimidating and can behave with aggression but have never actually hit anyone.
6. Sixth bias. Every perspective has value. An example will provide illustration. While
working with a staff team we asked them whether they believed that acting, as a role
model for adolescents in group care was an important part of the job of a
residential social worker. They agreed and all positioned themselves tightly around
the answer ``yes'' that was written on the ¯oor and well away from the ``no'' answer.
The next question was ``If the young people were here now and if we asked them
about what sort of role models they see in the team on a day-by-day basis, what
8. 352 J. Gibson et al.
would they say?''. There was stunned silence followed by honest re¯ection of the
fact that the team did not always display desirable role models at all. Adding the
children's perspective even though they were not there enabled the formation of a
systemic connection.
7. Seventh bias. Language is not neutral. We identify strongly with Richardson (2003)
on this point. She rightly states that language conveys meaning; words are used to
tell a story that de®nes and describes people and situations in certain ways. The
question is ``why this particular way and with what effect?''. We agree with
Richardson when she points out that in residential child care the most obvious
example is the daily handover meeting between shifts. How information is ``handed
over'', how meaning is construed, can have profound implications for all
concernedÐnot least as Richardson reminds us (2003, p. 113) ``for the characters
in the story'' (i.e. the children and their families).
Consequences of Systemic Dislocation
From our work with a range of organisations, we have observed attitudes and practice
that serve as examples of systems where there is disconnection between the parts. This
systems dislocation leads to dysfunction. Here are some examples.
d Teambuilding opportunities, while supportive, were less effective when not linked to
other factors impacting on the team.
d Organisations were demanding more specialist training when the foundation skills
were not in place.
d The impossible task of one staff attending training and expected to feedback and
share learningÐimplementation often requires a team approach best understood
when teams are trained together.
d Increased demand for training on physical restraint when early intervention/
diffusing skills are not there and concerns about a lack of a policy framework to
support and guide staff.
d Once learning has taken place essential systems are not in place to facilitate
integration of learning into practice (e.g. supervision, appraisal).
d Increased expectation that training will solve all problems when what is required is a
range of other responses (e.g. mentoring, coaching, team development, strategic
planning).
The opposite of dislocation is systemic connectedness, which is referred to as
``coherence'' by Brown, Bullock, Hobson, and Little (1998). Their research indicates
the importance of ``coherence'' between the staff's, the unit manager's and senior
managers' de®nitions of what the home is about. Our re¯ections on work carried out
both within Northern Ireland and in the Republic of Ireland led us to identify a
number of core assumptions that would lead to a better connection between the parts
of the systems that ``contain'' children's homes.
9. Child Care in Practice 353
1. The need for commitment and leadership at a strategic level that holds and
continually promotes the vision for the work.
2. An ongoing awareness of the external environment and its impact on the work.
3. Clarity of role and responsibilities within the internal environment and senior
management mandate, and ownership that includes active involvement in the
process. Residential child care teams often highlight gaps between themselves and
managers that develop into a barrier when not addressed. When Berridge and
Brodie (1998) carried out their follow-up study into a number of children's homes
10 years after their initial study, they found evidence of a decline in managers'
involvement in the homes.
4. The need for staff (and young people where possible) to be involved in decision-
making and part of the change process. Communication is critical.
5. The need for sensitivity to the speci®c context for each piece of work and the issues
to be addressed. One Health Board in the Republic of Ireland was able to respond
to the very speci®c needs of a child through provision of a tailored ``wrap around''
service while another unit was powerless in contributing to any decision regarding
placement of young people in their care
6. Recognition that learning can happen through a range of methods (e.g. training,
development, mentoring, coaching), but there must be opportunities for practice-
based learning and individual and team re¯ection.
7. Staff must be provided with time to process the impact of the work on themselves,
and the organisation needs to ®nd ways to review incidents regarding challenging
behaviour, sexuality, managing change to ensure trauma is reduced and more
effective responses developed.
Introducing a Systemic Framework
Building on what we have described thus far, our core approach de®nes a philosophy
that recognises that all parts of the system are inter-related and interdependent and
there needs to be recognition of this in order to effect and support change, whether
that is practice learning or team development or rede®ning the purpose of a unit. A
visual representation of this is shown in Figure 1.
Our diagnostic and assessment work with all of the agencies that we work with
includes an open and transparent audit of work in these keys areas. We also try to
reach an understanding of how the structure of relationships in the agency and
between the different parts of the system both shape and are shaped by daily events in
and around the provision of care to troubled children. The next section is an
illustration of how the MOSAIC team along with one agency worked to provide a
multi-element solution to a situation of chronic disarray.
A Case Study: Anxiety, Disarray and Crisis
This article began with a descriptive case study of a residential unit in crisis. MOSAIC
10. 354 J. Gibson et al.
Figure 1. A Systemic Framework.
was invited to undertake a further needs analysis and to offer solutions. On further
investigation, we found that the service was in crisis. We found caring people, direct
line staff, ancillary and support staff and managers desperate to do a good job for some
of the most seriously traumatised children and young people in our society. We found
young people who were angry, sad, and unhappy and who displayed moments of guilt
at some of their actions. We found young people who wanted adults to be in charge,
who wanted adults to show care and fairness but young people who, because of their
life experiences and distrust in adults and ``the system'', would resist the very aspects of
care that that they so desired. The MOSAIC consultants followed on from the initial
team meeting described earlier with visits of observation and interviews that sought
information from all parties on their views of critical system components. The result
was a programme of work that we outline in Table 1. The programme lasted 11
months and covered the following areas.
d Senior management support.
d Team building.
d Therapeutic Crisis Intervention (managing challenging behaviour).
11. Child Care in Practice 355
Table 1. Content of the Development and Training Programme
Aim Content
Residential staff To help equip residential childcare Team development 5 Q 1 days
workers with the training and
development that will assist them in
providing quality care for children
and young people in residential care
Therapeutic Crisis Intervention
trainingÐ27 staff trained on 5-day
programme
Child and adolescent development
Q 2 days
Childhood trauma Q 1 day
Managing sexual behaviour Q 1 day
Recording skills 1 day
Supervision skills 1 day
Senior To facilitate discussion, clarify issues 5 Q 0.5-day sessions providing an
management and support senior managers in opportunity to:
support their planning and decision-making
feedback issues/concerns/good
practice
facilitate discussion on strategic
issues
explore operational implications
review and as appropriate adapt the
programme
d Child and adolescent development.
d Childhood trauma.
d Managing sexual behaviour/therapeutic skills.
d Supervision and recording skills.
The programme content is presented in Table 1. A celebration event was held on
completion of the process with the presentation of certi®cates and feedback from all
those involved. Some staff comments included:
All parts of the training have been signi®cantÐtraining which has given me a great
knowledge base and teambuilding which has helped build better relationships with
colleagues.
TCI has been applied to my practice and has helped me deal with situations more
effectively ¼ makes us work more consistently and provides an improved service for
young people.
Coming together and airing our views has helped staff to be more open. Discussing ways
of dealing with the children has helped us deal more effectively as a team.
Conclusion
Residential child care is a complex activity and although it may appear contradictory
12. 356 J. Gibson et al.
to say it, ``care'' alone is not enough' (Bath, 1998). When residential care works well,
and when it fails, the explanation is never down to one variable. In this article, we have
shown that multiple variables are involved and that the way they interact creates a
structure and pattern of relationships that will either promote and facilitate quality
care or will, at best, get in the way of quality or will, at worst, abuse the vulnerable.
We think that systems theory and systems thinking provide a road map that can
illuminate key variables and the relationships between them. Thus, when troubled
children and young people in a residential setting are settled for bed at night, as well as
when they get on the roof at three o'clock in the morning, residential social workers,
team-leaders, ®eld social workers and senior managers might all begin to de-construct
the event by asking ``what is my part in this?''. The follow-up is a response that should
seek systemic explanations and solutions. It is our experience that single solutions like
staff training or moving troubled young people to yet another placement are never
enough.
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