ra tive tread mill’
and go straight to the
heart of the mat ter rather than join the
oth ers in al le vi at ing symp toms and re solv -
ing prob lems? Can we still claim
pro fes sional sta tus if we un abash edly ac -
cept the role of sur ro gate par ents
ad dress ing the needs of in fancy? And, if
we prove our point, will any body listen to
what we have to say? Well …..
Ref er ence
Stern, D. (1985). The In ter per sonal World of the
In fant. New York: Basic Books
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If you have read this ar ti cle please
send an email to the au thor —
fewster@seaside.net
(even if you
have no com ment).
M
y first ex pe ri ence with a CYC
Week was in Oc to ber of 1996.
In April of that year, I landed my
dream job, Pro gram Man ager of the De -
vel op men tal Neu ro psy chi at ric Pro gram
(DNP) at a state hos pi tal. It was a spe cial -
ized pro gram for the long term treat ment
of ad o les cents who had con cur rent di ag -
no ses of be hav ioural dis or ders and
learn ing dis abil i ties. It had a ca pac ity of 22
pa tients on three units, one for boys, an -
other for girls, and a third coed unit for
pa tients pre par ing for dis charge.
It had con sid er able re sources for these
22 chil dren–three psy chi a trists, five psy -
chol o gists, three teach ers, two so cial
work ers, a music ther a pist, a rec re ational
ther a pist, lots of nurses, and lots and lots
of Child and Youth Care work ers called
“Be hav iour Shap ing Spe cial ists,” BSS’s for
short. (Where do we come up with these
names?) Qual i fi ca tions for BSS’s were
high for our re gion–a col lege de gree or
sev eral years of prior ex pe ri ence in the
field. Pay was like wise rel a tively high.
Med i ca tion was de-em pha sized. Be hav -
ioural treat ment was the order of the day.
All of that at tracted me to the job–I con -
sid ered my ori en ta tion to be pri mar ily
be hav ioural and I looked for ward to
work ing with a team of psychologists with
more than ample staff and resources.
And so in Oc to ber, we came to ‘CYC
week,’ a week the hos pi tal set aside for
rec og ni tion of its di rect care staff–the Psy -
chi at ric Aides on other units and our
BSS’s. The hos pi tal made note of the
week on the sign at the en trance to the
hos pi tal where they posted var i ous an -
nounce ments. After that it was up to the
in di vid ual pro grams to rec og nize their
direct care staff.
The RN Man ager who hired and su per -
vised the BSS’s or dered color-co or di nated
T-shirts for each of her staff, a dif fer ent
color for each unit. The rest of us put on
a spe cial cov ered dish lun cheon for the
BSS’s on Fri day, with enough left over for
the eve ning and over night shifts. Trib utes
were paid. The RN Man ager told them
they were all spe cial, the back bone of the
pro gram. “You all do such a great job.
We could n’t get along with out you,” and
so on. One of the psy chol o gists gushed,
“You are all ter rific. We could not do our
jobs with out the data you people
provide.”
But it all fell flat. Ex tremely flat.
The prob lem was that the hos pi tal
treated their em ploy ees as dis pos able
com mod i ties. Com men da tions were ac -
tively dis cour aged be cause
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CYC-Online July 2011 / Issue 149
CYC Week – 1996
John Stein
com men da tions could make it more dif fi -
cult to dis miss em ploy ees if they ap pealed
their dis missal to civil ser vice. Dis ci plin ary
memos for any in frac tions were the
rule–dis ci plin ary memos helped to jus tify
dis miss als. Con se quently, em ploy ees
were readily ‘writ ten up’ for any in frac -
tions of the pol icy and pro ce dures man ual,
which was over seven cen ti me ters (three
inches) thick. It seemed as if the hos pi tal
was more con cerned with dis miss ing em -
ploy ees that with re tain ing them. The RN
Man ager on DNP had a reputation for
being especially strict with her staff.
Mo rale among the BSS’s was abys mal.
In the twelve months pre ced ing my ar -
rival, the turn over rate for our BSS’s was a
stag ger ing 95%. It’s not that we lost 95%
of our BSS’s that year. There were many
who had years of ser vice. But we had so
many more who left in their first few
months.
In time, I
con cluded that we had three
types of BSS’s. There were those new
em ploy ees who had no in vest ment in the
job at all and who left quickly, after dis cov -
er ing that the job was not for them. Then
there were those who had been there for
a few years. When they left, they could
with draw their con tri bu tions to the pen -
sion plan in which par tic i pa tion was
man da tory. It could be sev eral thou sand
dol lars. They also got paid for ac cu mu -
lated leave, which was often sub stan tial
be cause they ac crued leave in lieu of pay
for any over time they worked. They
worked a lot of over time be cause of staff
short ages due to turn over, and rarely
were ap proved to take ei ther their com -
pen sa tory leave or their va ca tion, again
be cause of staff short ages due to turn over.
More thou sands of dol lars. They ac tu ally
could count on a sub stan tial cash ‘bo nus’
for re sign ing, per haps enough for a new
car. Fi nally, we had the em ploy ees who
had been with the hos pi tal for many years.
They could not af ford to leave be cause
they had so much in vested in the re tire -
ment plan. So we had lots of dis grun tled
em ploy ees who left, and lots of
disgruntled employees who could not
leave.
So when the RN Man ager gushed
about how “ter rific you all are,” it did not
ring true. Many of her BSS’s had been on
the re ceiv ing end of her dis ci plin ary
memos. More, there was at least one
whom she was ac tively try ing to ter mi nate
and ev ery one knew it.
And when the psy chol o gist gushed
about the data the BSS’s pro vided... Their
most im por tant con tri bu tion, pro vid ing
be hav ioural data for the psy chol o gists so
they could re vise their be hav iour plans?
Re ally. I could just tell how im por tant a
part of the treat ment team that made
them feel.
In re al ity, BSS’s were dis cour aged from
form ing re la tion ships with the kids out of
fear that they would un der mine treat -
ment. Psy chol o gists did the treat ment.
They de vel oped the treat ment plans and
re vised them weekly on each child. And
they met in di vid u ally with each child on
their case load (of four or five) weekly to
dis cuss their prog ress–pro vided the child
was not on restriction.
The treat ment was be hav ioural, based
on the strict est of token econ o mies. Chil -
dren earned points for each ac tiv ity
pe riod, one for being on time, an other for
‘par tic i pa tion,’ and a third for show ing no
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