Syracuse University, School of Social Work, United States.
Syracuse University, School of Social Work, United States.
Child Abuse Negl. 2019 May;91:52-62. doi: 10.1016/j.chiabu.2019.02.001. Epub 2019 Mar 1.
Youth care workers in U.S. residential treatment centers (RTCs) provide 24-h care to youth whose significant psychosocial needs cannot be managed in a less restrictive setting. They have sometimes abused or neglected youth in their care. This study investigates staff perspectives on a new form of intensive oversight developed in New York State to prevent maltreatment of youth in care facilities. It asks: How does intensive oversight and investigation mandated by a state-run agency for the protection of people in care affect residential youth care workers in RTCs? Derived from a 15-month ethnographic study of an RTC serving a child welfare population conducted in 2015 and 2016, these results suggest that intensive oversight may have unanticipated consequences for RTCs, the youth care workforce, and youth in care. Consistent with other studies of regulation and surveillance in risk societies, participants reported that fear of prolonged and intimidating investigations, false allegations, and unavoidable violations of policy negatively affected their practice and contributed to staff turnover. Organizational consequences included serious staffing challenges and increased costs of overtime and administrative management of compliance. Some participants suggested that the form of intensive oversight studied here may have reduced the quality of care received by youth by disrupting therapeutic relationships, causing youth to be cared for by unfamiliar workers, and compelling workers to act defensively to prevent allegations rather than in the best interest of youth. We suggest that, under conditions of intensive oversight, youth care workers, like their clients, should be considered an at risk population whose well being is essential for the provision of high quality care. We conclude with modest recommendations to organizations and jurisdictions using or considering intensive oversight practices to protect the rights and safety of youth in RTCs.
美国住宿治疗中心（RTC）的青年照护工作者为那些有重大心理社会需求而无法在限制较少的环境中得到管理的青年提供 24 小时照护。他们有时会虐待或忽视自己照顾的青年。本研究调查了工作人员对纽约州为防止受照顾者在护理设施中受到虐待而开发的一种新的强化监督形式的看法。它提出了以下问题：州立机构为保护受照顾者而强制实施的强化监督和调查如何影响 RTC 中的住宿青年照护工作者？这些结果源自于 2015 年和 2016 年对一家为儿童福利人群服务的 RTC 进行的为期 15 个月的人种学研究，表明强化监督可能对 RTC、青年照护劳动力和受照顾的青年产生意想不到的后果。与风险社会中关于监管和监督的其他研究一致，参与者报告说，对长期和令人生畏的调查、虚假指控以及不可避免的违反政策的恐惧，对他们的实践产生了负面影响，并导致员工离职。组织后果包括严重的人员配备挑战以及加班和合规管理的行政成本增加。一些参与者认为，这里研究的强化监督形式可能通过破坏治疗关系、导致青年由不熟悉的工作人员照顾以及迫使工作人员采取防御性措施来防止指控而不是为了青年的最大利益来照顾青年，从而降低了青年接受的护理质量。我们认为，在强化监督的情况下，青年照护工作者应像他们的客户一样被视为弱势群体，他们的福祉对于提供高质量的护理至关重要。最后，我们对使用或考虑强化监督实践来保护 RTC 中青年权利和安全的组织和司法管辖区提出了适度的建议。
