A 16-year-old girl is referred to a crisis shelter after a 72-hour observation period at a psychiatric hospital. She is determined not to be a danger to herself or others, but she does have a well-demonstrated diagnosis of multiple personality disorder.
The shelter’s direct care staff expresses a lack of confidence in safely monitoring her for the requested 48 hours until she can be discharged to her legal guardian. Rather than deny her placement, the director of counseling, a 30-year veteran of the field, spends the next 48 hours becoming acquainted with the young woman through the different characters presenting as manifestations of her personality.
The unique combination of his training, experience and gentle nature enabled the organization to offer a compassionate yes, rather than a no. She is discharged after a successful respite in shelter.
As the fight for public dollars intensifies, and the ideological divide fractures further, the only way to function effectively in our field is to utilize methodologies validated through objective research and constant evaluation.
These safeguards prevent the infection of services by harmful or ineffective practice models that would endanger our commitment to do no harm. Disastrous results emerge from treatment models and policies founded on catchphrases and personal opinion.
There is no room for debate. Any professional human services operation must be held accountable to a standard of practice that demonstrates results that benefit clients who may or may not have the choice to participate in services.
With enough financial backing and promotional acumen, any practice can be presented as founded in research and objectively verified. I suspect that “evidence-based” is code for “liability-shared.”
When something bad happens, we need to prove we were doing things by the book.
Evidence-Based Practice is the current definition of by-the-book.
Less discussed are the individuals implementing these strategies. Their professional skills and unteachable attributes deliver positive, life-changing outcomes for those we serve, or mitigate the unintended consequences of our best evidence-based practices.
Beyond background screening and suitability assessments, recruiting and retaining the right talent is based on intuition as much as evidence. The only way to know if a person can handle the pressures encountered working with runaway, homeless, or ungovernable youth is to experience it with them. Here is some qualitative evidence to consider.
A youth care worker on a full-time shift takes it upon herself to make each youth a scrapbook of their time spent at the shelter with pictures and notes she writes about the specific strengths and gifts she sees in each of them.
Another makes handmade passports for kids in a shelter and they watch foreign movies together. After watching 15 films from around the world and discussing them as a group, he helps them get their real passports and inspires them to trek beyond their own neighborhoods and see the world.
The staff on duty monitored the weather with 15 kids at Anchorage Children’s Home in Panama City.
Forecast to be a Category 1 hurricane, their emergency plan prescribed sheltering in place at their building, rated to withstand a category 3 storm.
Overnight, Hurricane Michael became the most powerful hurricane to hit the area in recorded history.
As the weather deteriorated and the building suffered damage to the roof and windows, the youth workers lashed doors shut with extension cords or held them closed with their own hands, while their colleagues continued to administer medications on time, prepare food and document conditions in the log book. Once the storm passed, two of them ventured out into the destruction to find the executive director and bring him back to headquarters.
There are so many stories like this, but the real truth is that the everyday heroism of working with kids in crisis is in the mundane details.
Trusting their training and intuition to help them know what need is most acute in an environment of constant need is de rigueur for a youth care worker. They must understand the systems of care in which we operate, protocols for every contingency, and how to gently correct and teach teenagers who are on the brink of calamity.
There are no longitudinal studies measuring these individual acts of grace, nor are they necessary. As human beings who share the same needs of the kids and families that we serve, we are amply qualified to identify evidence-based practice conducted by evidence-based people.
As we continue to make strides in understanding and developing evidence-based interventions that guide families toward hope, we must also keep pace by investing in those who provide so much evidence that we could never do the job without them.
John Robertson is the Program Services Director of the Florida Network of Youth and Family Services. He can be reached at [email protected].