What’s In a Name ?

By John Stein

Date Posted: Monday, 15 June 2009


John Stein began his career in human services as a police officer, then worked as a community organizer while working on his undergraduate degree in psychology. He has an M..Ed. in Social Restoration and is a Certified Cognitive Behavioral Therapist. He has directed programs for both adults and children in corrections, residential treatment, and inpatient and outpatient mental health settings in Pennsylvania and Louisiana. He is the author of Residential Treatment of Adolescents and Children: Issues, Principles, and Techniques, 1995, Nelson-Hall, Chicago. Since his retirement six years ago, he has presented numerous workshops for parents and professionals and written several articles on children’s issues.


What’s in a Name


I have always disliked the term “child care worker.”

Don’t get me wrong.  I know what the term means to those we call child care workers – the people who care for children and who care deeply about them.  They work with children in good times and bad.  They develop relationships with our most troubled children and help them to grow and develop.

My concern is with what the term means to others.  To other professionals and the professors who train them.  To the social workers, psychologists, and psychiatrists who work with troubled children and who are most often chosen to direct our programs.  To state agencies who set expectations and standards.  To government officials and politicians who make decisions about funding our programs.  To the public.

While a rose may smell as sweet by any other name, rose is only a name.  It derives its meaning from the thing it names.  It does not describe.  It neither adds nor detracts from the thing we call a rose.

“Child care worker,” on the other hand, is a descriptive term.  It purports to describe what child care workers do.  As such, it limits how others think about the profession.  Indeed, many of these others do not see child care as a profession.  The term limits their vision.

In my part of the world, in and around Louisiana in the Southern USA, the term is used almost exclusively for workers in day care and residential treatment settings.  In other settings, people who work with children are called other things–counselors, mentors, teacher’s aides, activity coordinators.

Parents who use day care want their children cared for and returned in essentially the same condition in which they were dropped off.  They want them fed and entertained and kept clean and safe and given their naps.  They do not want the day care staff to take over or interfere with their parental responsibilities for raising their children.

Many here have similar expectations and place similar limitations on child care workers in residential settings.  They expect child care workers to provide basic supervision for children in their activities of daily living–get the children up, showered, dressed appropriately and off to school.  Make sure they do their chores and homework, go to their therapy sessions and get to bed on time.  Oh, yes.  And keep them from getting into trouble and providing consistent consequences when they do.  They do not want child care workers to meddle in treatment.  Treatment is the responsibility of professionals.

This vision of residential treatment is that of a place to live for children who cannot live anywhere else.  While the children live there, child care workers care for them.  Others provide whatever else the children might need, namely treatment from professionals–social workers, psychologists, psychiatrists, recreational therapists.

Treatment is, of course, confidential.  Therapists cannot divulge what goes on in therapy to child care workers.  And child care workers are discouraged from discussing anything with children that might have to do with therapy, from interfering with therapy by trying to treat these troubled children, from stepping on therapists’ toes, as it were.

Treatment professionals lament how difficult it is to treat these troubled children when the child care workers can’t even get them up and to school or to bed at night.  Or keep them out of trouble.

Meanwhile, child care workers complain about children coming back from therapy sessions all worked up over something.  They don’t know what happened in therapy and can’t talk  about it with the children.  And the therapist has left for the day.  It is, after all, 4:30.

It’s not like this in every setting.  We have a few programs in which direct care staff are called other things and entrusted with more responsibilities.  In these programs, therapists and child care workers communicate and coordinate in providing comprehensive treatment throughout the day and throughout the living environment.

But the other attitude, the one that limits treatment, is pervasive in my part of the world.  Anyone can do child care.  Anyone can supervise children during their daily routines.  Consequently, expectations, qualifications and pay are all low, sometimes less than for cleaning floors or “flipping hamburgers.”  Funding and agency budgets do not allow for more pay because expectations and qualifications do not demand more.

Yet we expect these child care workers to manage a whole group of children that our best teachers cannot manage even one at a time.  When therapists are asked to manage these children for a time in a pinch, they find themselves most challenged to do so.

Professionals lament the high rate of turnover in child care workers, blaming it on the low pay.  But they do little to increase funding or find other ways to increase the pay.

Meanwhile, child care workers lament the low pay, but they are more likely to leave their jobs because of the way they are treated and low job satisfaction.  They knew what the pay was when they accepted the job.  They took the job expecting to help troubled children.  Then they find that most of their time and energy is taken up writing log entries and reports, supervising meals and chores, driving children to school and appointments, taking vehicles for service and running errands for the program.  They are criticized evaluated on how they do these things; no one notices or cares what they are doing to help children.

Our child care workers, of course, do much more than babysit troubled children.  They have to.  They develop relationships with children, individually and as a group.  They help children develop their fullest potentials, personally, socially, culturally, intellectually, educationally, and morally. They help develop their knowledge, skills, abilities and understanding ; their expectations of themselves and of others ;  their goals.  And everything else that goes into the development of competent, confident, happy adults.  They do this both individually and within the living group, perhaps the most important setting for children to develop their values and their social skills.  But they must do all this, not with the support of others, but rather within the limitations placed upon them by others.

The vision of residential treatment should be much more than a placement of last resort.  It should be of a placement that can meet all the needs of children with multiple problems.  All of these children have problems with their behavior, but their behavioral problems are more often symptoms of other more serious problems – emotional problems, problems with relationships, with self-confidence and self-esteem, with values and faulty belief systems.

All of these children have needs.  They have the normal developmental needs of other children their age.  They are likely to have remedial needs to catch up with other children their age in certain aspects of their lives.  And they have treatment needs related to their own special circumstances.

The vision of child care workers should be of people who are in the best position to meet the developmental needs of troubled children and facilitate their treatment.

Perhaps if we called them “Child Development Workers,” or “Child Development Specialists,” rather than limiting our vision with restrictive terminology, we might begin to develop and expand our vision for these essential people and the programs in which they work.