THE ROLLER COASTER PROFESSION.....CHILD AND YOUTH CARE IN SOUTH AFRICA

There is again concern on social media that child and youth care workers are leaving the profession. This time,  having studied social work whilst employed, or are currently doing so, or are moving to education, or are simply leaving. Reduced numbers    can't be filled with the through flow of graduates or child and youth care workers with a Diplomas.This leaves vacant posts, or else, a compulsion for child and youth care workers at the auxiliary level to perform some of the more advanced tasks in the scopes of practice.

There was a book shown on Facebook last week called Social Work The Rise and Fall of a Profession. It's context is the UK, but I thought the title captured something of the trends in the child and youth care profession in South Africa. The cover of the book shows a roller coaster ...the upward hikes and the scary drops. In previous blogs, this analogy proved useful....the rises and the falls for us as child and youth care workers in South Africa has spanned decades.

The first Professional Board for Child and Youth Care was inaugurated in 1998 after years of being statutorily in the Council for Social Service Professions Act. The first five years were spent drafting regulations for the registration of child and youth care workers at the Auxiliary and the Professional levels. The scopes of practice became a hurdle. The question was always, how does child and youth care practice differ from other helping professions and does it have enough original content to make it a separate profession? Was child and youth care yet a profession or an emerging profession, or an occupation that needed to first be an extension of the arm of other "established" social service professions. It was an ongoing debate.

Academics saw child and youth care as belonging in their various academic departments....Social Work, Psychology, Mental Health Care. All this resulted in there being no elected Professional Board for Child and Youth Care for a full 5 year term. No warm bodies.....No Board. The Department of Social Development came to the rescue and funded an "Interim Committee/Board" which functioned to continue the work in the interregnum.  

The 18th draft of the proposed regulations was signed into law in October 2013.
( See: Lodge. B. 2015 Relational Child and Youth Care Practice, Professionalisation of Child and Youth Care Work in South Africa Vol 28, No4, p5.)

It was in that period that Social Work was declared a scarce skill     (and a critical skill). Like the UK, it was experiencing a "down". Poor salaries resulted in numbers of social workers drifting away....leaving the profession for industry or the UK. Study bursaries were made available to offset the dwindling numbers. It worked. Some say that it worked too well as there was a time when we had unemployed auxiliary and graduate Social Workers. I am saying this because bursaries for university study were not available for child and youth care workers at that time and the University of South Africa shut down it's child and youth care degree. 

A very successful model for community-based care called Isibindi was designed and rolled out nationally by the National Association of Child  Care Workers ( NACCW). This provided employment of large numbers of child and youth care workers and learners at the auxiliary level. In 2013, the then Minister of Social Development undertook to adopt Isibindi as a national  model. The Department financed the training of 10,000 child and youth care learners.The learners were paid a stipend and required to register with the South African Council for Social Service Professionals.The agreement was that for 5 years the NACCW would be the training service provider and employ the mentors to ensure the continuity and standards of the model. . In the five year period social media hosted expressions of disappointment by child and youth care workers in comments that they struggled to find appointments into the more senior posts.

The contract ended in March of 2018.

Social media exploded. Some Provincial Departments announced a "dry season"....no funds...no pay.  Delayed payments of stipends, suspended training. Some projects closed. Qualified child and youth care workers at the auxiliary level were still paid learner stipends. Monies in the community based projects bore no comparison with child and youth care workers in residential facilities.

Here began the drift, reminiscent of the social work crisis of 2012/2013.

In 2017, National strike action was taken. It lasted 6 weeks The trade union had a 13 point list of demands. They included better and equal salaries for all social service practitioners, the removal of the ceiling placed on the salaries of child and youth care workers at levels 4,5 and 6 on the Occupation Specific Dispensation (OSD). It was agreed that these demands would be met on the 31st October 2017. The date came and went and were not implemented. Apparently changes to the OSD have to be made at a very high level in the National structure and can or do take a very long time to fix. 

This week on social media, it seems that child and youth care workers may be running out of patience. It was said ...they can't wait.

This brings us to this week's social media posts.

The move of child and youth care workers out of the profession is a matter of concern. In one province it was said ... Yesterday only 38 child and youth care workers were transferred to Social work.
More are doing social work studies at the auxiliary level.
" Our profession is dying a slow and painful death". Social media comment speaks of confused and mixed emotions. Even now, one child and youth care workers in one of the provinces said that in their project they had not been paid since October of last year. (Sometimes this can be a problem within the holding agency)

There is evidence of a lift. Training and compulsory training is emerging. An Isibindi styled model is underway. There is talk of more universities interested in offering a professional degree in child and youth care work. Some provinces, it was said, will or have made increases in salaries  ( if little)

AND the resilience and loyalty of child and youth care workers to serve the best interests of the nation's children persists as a beacon of inspirational light. Child and youth care workers are encouraging each other not to become despondent, but to hang in. Feels as if they are anticipating another haul upward on the roller coaster.

STAFF BURNOUT....CHILD AND YOUTH CARE IN SOUTH AFRICA

This week the blog is (somewhat) longer than usual. 

Social media post: "I burnt out - only now referred to a psychologist" The organisation blamed for the lack of support and caring, delaying intervention until it was too late and an implied apparent unenthusiastic referral to external professional support. The post raised comment. "Does the organisation pay for your medical aid?" "Were you given proper supervision? " There was perhaps a masked hint that the workplace could be "toxic" ( another word being bandied about on social media now).

All relevant. All important.

What then, is burnout? .....Burnout in the helping professions has also been called Compassion Fatigue. With constant stress you have a feeling of helplessness and are completely exhausted. Problems seem insurmountable. Detachment threatens your job and your relationships. It is a state of physical and emotional exhaustion. (adapted from www.helpguide.com).

Some serious questions surface. Who cares for the caregiver? Who cares for the carer of the caregivers?

I know burnout......been there twice. Each was a different experience. 

The first time I had no idea that I was burnt out. At 5.00 one morning I got out of bed to go wake the boys. But I sank to my knees next to the bed. There came from within me.....from the very pit of my stomach a loud wail, a scream. I didn't initiate it. I had no control of it. It just welled up frightening me. I called it a "primal scream". Crying all the way up to the boys dorm. I experienced an increase in my heart rate. I felt trapped - no escape.

Looking back, the actual workplace situation was something I should never have allowed for myself. No breaks, no leave, no weekend off early 'til late. Neglect of family, relationships, doing two jobs at once, on constant call and every day a new huge child related human drama to be faced. Some would say it's the calling. I now call my burnout my foolish self uncaring.

It's the old story. On the aeroplane you are told......fix your own oxygen mask before helping others.

I referred myself to a doctor. I think that he experienced physical state. My psychological state was a mystery to him. He didn't recognise compassion fatigue. only anxiety. So, he prescribed Ativan. Ativan is used for anxiety and some neurological brain irregularities. I was not anxious I was physically and emotionally worn out, now with nothing more left to give. The Ativan got flushed down the toilet. It has a reputation of becoming addictive.

I insisted on three days leave in in my caravan in the Hogsback mountains with my family

It was as I had thought. Came back to chaos. The children had pulled every wire in the building to set off the fire alarm. It was to create an emergency dramatic enough to get me back. There was a fear that I would never return. Something very wrong. Organisationally, children can't be that dependent on one person. For some child and youth care workers it may feel good to be so needed, but its part of the toxic workplace.

There was a psychologist, the only psychologist in the city at that time. He sat on the management board. He was the one to see the signs ( after the event). He volunteered his time then to give me 6 months weekly, what he called, supervision. It was really psycho therapy. A life saver, a job saver. The problem was I had allowed myself to get sucked into a toxic workplace of my own making.

There was a child and youth care worker heading toward burnout. She recognised the symptoms,. Shut herself in her room one day. We asked why did you not pick up the phone we have a policy to organise a retreat, support and relief. She said, "This is a place of caring. Why should I have to tell you I need care? You should have noticed". I'll never forget that. She was right, but only partly right...The oxygen mask story again. It really should not be like this, but if you  need care you sometimes have to take the first step

This makes it important to recognise the signs of burnout.

My second burnout was somewhat different. I found myself focusing on small things. To protect myself from feeling overwhelmed and not coping. I focused on the easy to handle and deliberately avoided the major pressing issues. Any form of confrontation for example. A brooding, looming disaster. Like, I'm a very tolerant person but the toilet roll must not be in its holder the wrong way round. A child smoking becomes an issue when he is facing a major relationship breakdown not addressed. Responsibility was reversed. "I am to blame" The children's behaviour became my fault, my inadequacy. In a toxic workplace that is an organisational norm and heavily underscores faulty child and youth care thinking, especially by management. 
There were emotional symptoms. I lived close to tears all the time Without actually crying tears. The inside of me was crying. Not a primal scream this time, a primal weeping. Physically the experience of fatigue was overwhelming. It was a huge effort to go to work, to respond to call - outs, to focus.

Then came the heartbeat thing. This time coupled with nausea. The doctor ruled out a heart attack. Prescribed a tonic.

Again, a Psychologist board member came to the rescue. Six months weekly therapy.There is a lesson here. It's not shameful to be in therapy if you are in the helping professions.

What then is the treatment.?

The most obvious answer to this is that prevention is better than cure. It really is the facility, organisation or programme's responsibility to provide policy, procedures, services which prevent burnout. Also to provide immediate intervention if it should occur. 

There some unnegotiables. the organisational imperatives for the avoidance of staff burnout.

Regular supervision.....and by this I don't mean hierarchical "snoopervision".  I mean personal "inter-vision" "I did this. "I felt this". I'm feeling".........proper supportive workplace supervision with a child and youth care worker. Not with someone from another profession, and not the manager. Not with someone who will say, pull yourself together. Go get vitamin B12 or a tonic.

Then comes case-load. When I had my first burnout I had a full junior and senior dormitory of boys in my direct care. and then the young people who had been placed in boarding schools but were attached to the facility. 8 - 12 is recommended with support.

Long working hours. This idea of 24/7 is obsolete and illegal. The practice of long shifts even if kept within the weekly limits of working hours as set out in the Conditions of Service Act. The 12 hour shift has risk of negative effects on staff performance on that day, and so burnout risks.

The boss. Has to be alert and caring as well as really understanding of the work of child and youth care. Studies, serious research frequently quoted also in the social media has shown that a poor boss can make employees sick. Most employees leave, not because of the work but because of the boss. The boss doesn't have to be a single person. Quite often the boss is an external system.

A team approach. Child and youth care workers can't do this on their own. It's a team thing. A child and youth care worker can and should have focus children or a focus group. What we call the primary worker, but there has to be a team. A team of like minds, real support, caring and skills at different levels. Left to be responsible and accountable on your own contributes to burnout.

Self care is essential in the prevention of burnout....Remember the oxygen mask story. The seven R approach is useful: 
RECOGNISE the warning signs
REVERSE THE DAMAGE by seeking support
RESILIENCE take care of your physical and emotional health
RECREATE have other interests and use time to REFLECT, RECOVER and RELAX.

This implies regular leave.  It must be allowed and taken No such thing as "pay out in lieu" or a few days here and there.

Burnout should not be allowed to happen. The question of treatment of it, is a difficult one. It HAS to be HOLISTIC. No single pill. No three days off story.Treatment has to address the physical, social, family, emotional, cognitive (an individual staff development plan), spiritual and life-stage task domains. It does mean that you may have to get help from a psychologist, compulsory leave which should be sick, or special leave, a plan for personal development, the 7 R's , and an overhaul of the organisation's practices. A support group is essential. Be prepared to have your friends support. But also, child and youth care workers need to gather supportively around a colleague in the recovery period. Social contact is essential to the recovery of burnout.
Management must be be particularly caring and supportive of the needs of child and youth care workers and to provide organisational safegaurds against compassion fatigue occurring or re- occurring.

How wonderful it would be if questions about burnout and its treatment did not have to be asked.

Child and youth care burnout should never happen

Perhaps more accurately, child and youth care burnout should never be allowed to happen. 

SOCIAL MEDIA AND ETHICS.....CHILD AND YOUTH CARE IN SOUTH AFRICA

There appears to be a gap in our child and youth care Codes of Conduct, Code of Ethics, Guide for the policies of the course of Ethical Conduct for Social Service Professions. None of these refer to social media ethics specifically. There is obviously a flow over from what is contained in the Regulations attached to the South African Council for Social Services Act . It's just that it would be appropriate in this digital age for social media to get specific mention. All the regulations on ethical conduct for Social Service Professionals  regulate the Acts or Omissions Deemed to be Unprofessional or Improper include a section which has to do with behaviour which, with due regard to the prestige, status and dignity of the profession, is detrimental to his/her position as a social service professional. This then applies to child and youth care workers.

It is unethical for us to publicly criticise other Social Service Professions or professionals. Yet social media appears to be regarded as immune. It's used in the bigger context as freedom of speech.  

I remember being given an example of unethical speech freedom. Apart from hate speech. In a crowded cinema it is illegal to yell "Fire!, Fire!" when there is no fire. Unnecessary panic and anxiety and fear is aroused. A mass exodus through narrow exits put people of risk of harm. So it is in our profession. Yet, so often we see the cry of "Fire" when there is a smouldering in a corner of the profession which can be contained.  The risk....   a mass exodus. There is clearly a difference between advocating for the profession as a whole on social media and using it to drag contextually specific issues into the digital arena.

We all actually know, what we say and do and how we are perceived in the wider community has ethical implications for our profession. Once a professional, always a professional. In social media this appears to be frequently disregarded. What if our clients, children and young people search our time-line on facebook. And it IS done! I'm told that employers check out time lines as background checking of the references of work applicants. If they do it, then our young people in care can do just that....and will. What will they find there? 

If some of the posts I sometimes read and see is any measure, - then whoooo!

I am NOT GENERALISING. In some posts only. Private life is exposed. Stuff we would never share with our clients. Sexual behaviours, relationships, allegations, family issues Much of what, as professionals we keep to ourselves and to our close friends perhaps our family. But, there it is, for all to see and read. Believe me, I'm not writing this as a prude, but as a professional. At a personal level there is much which is beautiful, witty, insightful, but my concern is how will our posts be interpreted by the children and young people in our care if it appears on our timeline? Provocative poses, Explicit wording, expansive cleavage, bulging crotches.???

There is another social media trend. It's the open often vilifying criticism of the workplace. In terms of our ethical behaviour toward the employer, there is reference to our not criticising the workplace in the public media....interpreted as newspapers and TV. Social Service Professional ethics as well as workplace codes of conduct simply disallow this. There was a post which said there is a workplace manager who made it policy that if he/she makes a friend request on Face Book, staff members are requires to accept. Not at all sure of the ethics of such a policy !!!! It does though, speak volumes of employer anxiety that internal workplace or personal criticism will be exposed on social media.   Social media seems to be interpreted as "Chatting to friends", which it may be. But social media can be a public medium  depending on how it is used or managed.  So, some texts are a diatribe of organisational criticism. I was once told that anything in the digital arena is in the public domain It can be used. It can go viral'. It can be a yell of "Fire! Fire" in the crowded cinema. There ARE other forums, other platforms, for this.

The use of a question on social media allure other professionals to come out and uncover within organisation/facility criticisms. The questioner is protected, when others, I think, in good faith, may put themselves at risk.

None of this means that we, as child and youth care workers are closed off, that our freedom of speech is stifled, The use of administrated groups, closed groups, and privacy settings can allow us protection as professionals. I was given lots of advice when I went onto use social media. Much of which I have ignored, I'm afraid to say. Like, use LINKIN for professional contact. Have a family group for family matters. But I like facebook. It is interactional, stimulating, and is a platform for us to keep informed, to debate and to make plans. JUST..ethically,....  be guarded. Be safeguarded. It's the public nature of social media that place us at most risk of  possible professional ethical complaint.