At a meeting of the 7 Pioneer agencies in March, 2010, it became apparent that the evaluation as designed would capture outcomes, for children, staff and agency, but would not capture the process of change.

Thus a qualitative element was added, and over 70 interviews were undertaken across the 7 agencies along with some site observations.

What have we learned about embracing and influencing change in agency cultures and care practice through the implementation of CARE?

What can we learn from agencies that have been engaged in implementing CARE over a 2 to 3 year period?

What does the process of change involve?

Characteristics of the CARE Approach

• The agency is the locus of learning. Rather than seeking training outside of the agency, the agency itself becomes the primary learning site.

• The agency is the unit of learning, rather than the individual (or even the team). While individuals are engaged and learn, the emphasis is on transforming the organisation as a whole.

• The CARE consultants are engaged in a co-learning and co-creation process alongside the agency staff members; all participants are learners.

• CARE recognizes and seeks to bring forth the potential of adult learners to address the experiences and needs of the children.

• Key to the success of CARE are processes that keep the dialogue and critical thinking moving forward through ongoing conversations throughout the agency, both within and across organizational levels.

• CARE recognizes the true complexity of child care work.

But how does the implementation of the CARE program model

actually work?

Best Interests of Children

Six Core Principles

Beliefs, Attitudes and Assumptions

Change Facilitation

Integrating CARE Model

Staff Development

Organisational Climate & Culture

Interlocking “nested” elements in translating the CARE program model into practice

The “holding” organisation, containing staff and children,and especially their anxiety and pain

political change and expediency

media criticism and attacks

society’s anxiety and pain re: children

makes peoplewant to putthe lid on

6 Principles

Beliefs. Attitudes.Assump’ns

Staff Development

Change Facilitation

Integration of CARE

Org’l Culture & Climate

In the

the child’s best interests

The Core of CARE

Every agency thinks it is acting in the best interests of children,but in fact many are not, at least not in any consistent manner.

Six Foundation Principles

Developmentally-focused

Family-involved

Relationship-based

Competence-centred

Trauma-informed

Ecologically-oriented

Not a single person in over 70 interviews across 7 agencies disagreed with a single principle

Beliefs, Attitudes, and Assumptions

Children do well if they can...

Have expectations instead of rules

Rules are for safety

Do with, not to

From points and levels to therapeutic conversations

From reactive to responsive practice

From compliance to self-regulation

From attention seeking to attachment seeking

Teaching, not controlling

Building relationships, not behaviour management

Getting on the same page

Internal versus external motivation

Meeting needs, not just imposing consequences

Think before responding

Zone of proximal developmentPain-based behaviour, not misbehaviour

Discovering. not judging

Elements of the Change Facilitation Process

Validating

Communicating empathy

Modeling

ProbingAffirming

Challenging

Analyzing case examples

Self-disclosureQuestioning

Sharing illustrative stories

Paraphrasing

Providing information

Observing

Creating the context for change

Joining in the task of agency evolution and supporting changing mindsets

Commitment to CARE by agency

Embracing 6 principles

Understanding key concepts(beliefs, attitudes, assumptions)

Working through applications

Re-

Re-

Re-

Re-

Re-

Re-

Integration of the CARE Philosophy/Approach

Experiencing CARE effectiveness

Gaining confidence

Supervisors

Leaders

influence influence

Child Care Workers

•CARE involves much more than skills training or knowledge transmission.

•Putting CARE into practice requires the ability to move beyond technical thinking (“if x, then y”); it requires adaptive thinking (“what is going on here, and how can I be helpful?”)

•Ultimately, it is about mindset, and the need to think and act in an integrated manner with an appreciation of complexity.

Two of the most common statements from agency staff about learning and implementing CARE were “it’s about changing your mindset” and “it’s thinking outside the box”.

And changing a mindset involves all aspects of one’s being.

Staff/Adult Development Domains

Cognitive/intellectual

Affective/emotional

Moral/spiritual

Social/affiliative MINDSET

thinking

feeling

meaning

relating

At the heart of implementing CARE is creating an agency culture and climate that supports the development of a new CARE mindset (not simply a commitment or intention) amongst all staff members.

It became apparent that the implementation of CARE involved some form of adult development.

But how was this adult development process actually working?

What was all the data from the many hours of interviews telling me about the mindset struggles people were experiencing and talking about?

And lo and behold, a fortuitous conversation with a graduate student brought me the framework I was struggling to create.

The slides that follow are based on the work of Robert Kegan and Lisa Lahey outlined in their text Immunity to Change (2009). Their research:

•identifies the struggle that people in many walks of life have in adapting to the increasing complexity of the world in which they work, and

•offers an explanation for how and why some agency staff members are able to embrace and act in accordance with the CARE model while others are not.

SocializedMindset

Self-authoringMindset

Self-transformingMindset

Increasing complexity

Adapted from R. Kegan & L.L. Lahey, Immunity to Change (2009)

Socialized Mindset

•Prefers dealing with concrete realities rather than abstract concepts• Focusses on technical solutions (“if x, then y”) • More at ease following rules than being self-directed• Holds beliefs, values and assumptions and is not self-aware or self-critical about them• Comfortable following external authority

Self-authoring Mindset

•Works from a framework of understanding • Is comfortable working with basic concepts•Seeks to create adaptive responses to new and complex situations• Is generally self-directed and comfortable taking responsibility for own actions• Is reflective and self-critical about own beliefs, values and assumptions• Is able to question external authority and draw on inner resources (thoughts, feelings, understandings)

Self-transforming Mindset

•Understands relations between concepts and can create new concepts as required•Thinks systemically and is comfortable with changing systems and creating new systems• Is self-authoring and self-transformative (i.e. can change own beliefs, values and assumptions)• Is highly self-aware and able to self-criticize• Is comfortable with ambiguity & uncertainty• Is comfortable leading others with sensitivity to their needs and realities

For work of a technical nature, a “socialized mindset” is often perfectly adequate to the task.

However, the findings from this research suggest that to be able to implement CARE, one needs to have developed, or at least be willing and able to begin the task of developing, a “self-authoring” mindset. It is also preferable if supervisors are functioning to a significant degree at this level in order to model and support others to progress in this direction.

A number of agency leaders demonstrated characteristics of a “self-transforming mindset”.

A Congruent Organisational Culture and Climate

Openness to change/ lack of rigidity

Safe to make mistakes

Integrates learning mode into operating mode

Leaders model learning mode

Develop a common languageWorking on the same page/lack of role conflict

Accountable to same goal or purposeWork environment experienced as supportive

People valued as individuals

A congruent agency is needed to sustain the developmental processes

Agency leaders become aware of the need to review and revise their agency policies, procedures, practices, and structures, in order to be congruent with CARE.

Workers in CARE agencies often report that things are more calm and peaceful in the cottages, there is less fear, there are fewer confrontations and power struggles, and fewer restraints (in one case none). Many workers report they are happier and feel more satisfaction in their work.

yes, some workers are not able to adapt very well to the CARE philosophy and approach, and actively “resist” or “fight” the model. They need assistance to understand their reaction and to make an informed decision about their future.

Residential child care is demanding work, however the CARE program model offers the potential benefit of significant personal and professional developmental growth for those willing and able to commit to it.

If this sounds too good to be true...

When asked how long it took to feel that they had become a CARE agency,most respondents indicated “about 2 years”.

When asked how long it took to see differences with the children, the response was invariably, “right away”!

According to Pioneer agency respondents (as of July/August, 2010), the estimated degree of attainment of a consistent CARE approach, after approximately 2 years, ranges from about 45-50% to 80-85%.

In the past, there has been a tendency in the child welfare field to oversimplify the needs of children in residential care,

thus oversimplifying the nature of residential care work,

and therefore what it takes to do this work well.

Summary

The CARE Program Model embodies an appreciation of the complexity of residential care, and offers a framework and process for systematically improving residential care practice at both the worker and agency levels.

At the same time, CARE is a work in progress, and the research being undertaken is bringing forth data and understandings that can help to improve the model and how it is implemented.

Some Implications of this Study• CARE is “big”, even profound in its

implications; it engages in challenging and transforming our mindsets and, therefore, our identities and our sense of self.

• Understanding the current mindsets of staff can assist in the provision of individualized training (support for development) and supervision, and help with the selection of staff for supervisory and leadership roles and responsibilities.

• This analysis of the CARE implementation process suggests that consideration be given to developing further the adult learning components of CARE in line with new theories and understandings about how adults can increase their mental complexity (i.e. change their mindsets).

• In addition, each of the six principles has extensive literature that can be drawn upon ever more deeply as a useful resource for staff and agency development.

Residential care is not rocket science;

it is far more complex than that!