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Paper

Experienced practitioner views of good practice and optimal services for challenging youth

abstract

Background. This paper is derived from a study concluded by the author in 2007. It tapped the views of practitioners with substantial experience in Victorian service systems expected to deal with challenging young people. The principal vantage point was the interface between the supported accommodation and assistance programs for homeless young people, statutory child protection and care, placement and support programs for young people at risk and juvenile justice programs for young offenders. The nature of the problem necessarily included some consideration of mental health and services dealing with substance abuse. The study was also informed by the researcher's experience in both institutional and community based settings in Victoria through successive eras of social policy over four decades including some recent direct service with challenging young people. This affirmed the ongoing nature of some practice and systemic difficulties in this work.

The captured views of experienced practitioners were considered in the light of insights from the literature to formulate grounded theory to inform practice, service development and further research.

The research problem. Some young people present behavioural challenges to the degree that they are excluded or abandoned by programs or allocated to stronger more intrusive responses: such as, assertive outreach, sometimes family work; intensive case management or supervision programs; therapeutic programs or settings, or placement in secure welfare or other custodial settings. These tend to be costly and intrusive (sometimes coercive) services leading to limitation through targeting, rationing, restrictions on access etc. for both economic and political reasons. Practitioners are often faced with dilemmas in balancing autonomy for the young person and limit setting - empowerment vs control and in achieving access to opportunities the youth will accept. Practice approaches and the cost, quantum and mix of service elements are uncertain and at times contested.

The research questions and method. A qualitative research approach informed by the Glaserian grounded theory tradition pursued four broad research questions through in depth interviews with a purposive sample of fourteen practitioners with at least five years experience of dealing challenging youth. The questions explored the practitioner's construction of good practice and factors enabling or impeding it and their vision of an optimally effective service system.

There were three waves of data collection and analysis in the pursuit of theoretical redundancy. Some assistance in analysis was obtained through the use of NVivo and a summary aided approach to identify core categories sought for grounded theory.

Findings. The findings propose a view of good practice giving emphasis to the accessible and assertive presence of a responsible adult to "be there" fostering intentional relationships and skilled purposive intervention. Intervention should be planned, holistic, sensitive and responsive to particular individual needs. It provides active unconditional care. It attends to attachment and trauma concerns and works with short run goals and a long term perspective. Intervention is sustained until constructive disengagement can occur.

The complexity and challenge in the task of helping hurt and acting out youth warrants the support, strength and guidance of a multi-skilled team. Ideally the team will be described using normative terms. Optimal services are timely, congruent, seamless and robust in capacity to nurture, establish boundaries and meet developmental and therapeutic requirements. They should be connected to a community with ready access to suitable accommodation, purchasing power and flexibility of operation. To the greatest extent possible solutions are generated in the place where help is sought. Voluntary service commitment lasts till personal capacity and natural networks take over.

Implications and recommendations

Policy - the tendency for services to be episodic, short term and tightly rationed is disputed. Robust, local, flexible intervention teams are recommended.

Professionals - interdisciplinary and multi-skilled orientations are warranted with strong emphasis on intentional relationships and purposeful intervention.

Research - trial and evaluation is warranted as is further grounded theory work on behaviour management and limit setting.

Key references

Clark, R. (2000). It has to be more than a job: A Search for Exceptional Practice with Troubled Adolescents. Melbourne: Policy and Practice Research Unit, Deakin Human Services Australia.

Owen, L. (2007). Looking for Good Practice and Optimal Services for Youth Facing Homelessness with Complex Care Needs and High Risk or Challenging Behaviour. Unpublished doctoral dissertation, Faculty of Health Sciences, La Trobe University, Bundoora.

Success Works (2001, March). Evaluation of the high risk service quality improvement initiative. Report to the Victorian Department of Human Services.

Contacts: Dr. Lloyd Owen, School of Social Work and Social Policy, Faculty of Health Sciences, La Trobe University; Bundoora Vic. 3083 Australia. Address for correspondence. 1 Skene Street, Newtown, Vic. 3220, Australia, E-mail: lloydsowen@bigpond.com, Phone +61 3 5221 0923.

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