June 1 2015

The Child and Youth Care Association of Alberta

#202 (B), 6715-76 Ave

Edmonton AB T6B 0A9

Ph: 780-448-7254 Fax: 780-448-9159

Honorable Fred Horne

Minister of Health
Legislature Office
208 Legislature Building
10800 97 Avenue
Edmonton, AB
Canada T5K 2B6
Phone: (780) 427-3665
Fax: (780) 415-0961

Dear Honorable Mr. Horne,

The information in this application has been updated to accommodate the changes implemented at Mount Royal University. Mount Royal University has suspended applications for the diploma program but will continue to offer a Bachelor of Child Studies degree program please accept this revised application.

On behalf of Child and Youth Care Counsellors employed in Alberta, the Child and Youth Care Association of Alberta, is submitting this application requesting that the Health Professions Act be amended to include the occupation of the Child and Youth Care Counsellor as a regulated profession.

Child and Youth Care Counsellors provide direct services to children, youth and families who are at risk. A population which has had numerous incidences of reported abuse and is constantly at risk of being further traumatized, if not provided with professional interventions. The services that are provided by an educated Child and Youth Care Counsellor offer additional protection to the public, due to fact that the treatment of abused children and youth has made significant gains.

One of the results of being abused is that a child can act out violently. In the past year, two Child and Youth Care Counsellors have been killed in the line of duty in this province. In order to intervene successfully with this population, the most skilled workers need to be identified and regulated.

There is a lack of means to investigate formal complaints, administer correction or discipline for those who engage in incompetent, unethical, or impaired practice, which places the public at considerable risk. Since membership in the Child and Youth Care Association of Alberta is voluntary, there is a lack of ability to enforce protective standards pertaining to qualifications, continuing competencies or requirements for practicing in this field.

The Child and Youth Care Association of Alberta is asking that Alberta take a leadership role and be the first in the world to protect this vulnerable population- by legislating the field of Child and Youth Care.

Respectfully Yours,

Making Alberta Safer for All Albertans,

President: Carmen Roberts-Kowalchuk

Child and Youth Care Association of Alberta

Introduction:

To ensure that the public’s best interests are protected, the Child and Youth Care Association of Alberta contend that the occupation of a Child and Youth Care Counsellor should be regulated, under the Health Professions Act of Alberta. Due to the fact that membership in Child and Youth Care Association of Alberta is voluntary, there is no means to regulate: the educational/continuing competency standards and requirements for practicing in this field. If a person practicing in this field is not a voluntary member of the Association, there is no means to investigate formal complaints or administer correction or discipline for those who engage in incompetent, unethical, or impaired practice which places the public and consumer at considerable risk.

History of the Field of Child and Youth Care:

The field of Child and Youth Care began with the Child Savers of Alberta at the turn of the 20th century. The Child Savers were volunteers whom wanted to help homeless children. During the 1930s economic times left the care of orphaned and abandoned children to religious groups. During the 1940’s and 50’s, group care and correctional facilities were developed in Alberta. This signaled the beginnings of Child and Youth Care as a paid career. The skills required by these positions grew to such an extent that formal education was required.

In 1970 Grant MacEwan College offered the first post secondary education program for Child and Youth Care called the “Youth Development Program”. Now there are five Universities and Colleges in Alberta that offer degree, or diploma programs for this field of practice. The body of knowledge for a Child and Youth Care Counsellor includes the concepts created by authors Fritz Redl, David Wineman, James K. Whittaker, Albert E Treischman, Larry K. Brendtro, Bruno Bettleheim, B.F. Skinner and Carl Rogers who provided the foundation for therapeutic practice.

In 1971 the Child and Youth Care Association of Alberta was established. In the 1970s a study was conducted by the Department of Social Services and Community Health to identify the knowledge and skills required performing the duties of a Child and Youth Care Counsellor. Through this study a training curriculum and an effective method to assess individual competencies was developed and called the Certification Program. In 1979 the first Child and Youth Care Counsellor was certified in Alberta. The Certification Program was available to employees of the Department of Social Services and Community Health. Interest grew from the private sector in gaining access to this program for their employees. In 1983 the Alberta Association for Services for Child and Family (now known as ALIGN Association of Community Service) submitted a proposal to the department requesting that the certification program be available to all Child and Youth Care Counsellors working in Alberta. In 1985 access to the certification program was granted and transferred to the Child and Youth Care Association of Alberta. In 1989 a Certification Board was created and in 1994 this Board was given control over all revenues created by administering this program. In 2014 the Certification Board became a standing committee of the association. Over the years the practice of Child and Youth Care has made significant developments. The knowledge base, competencies and certification information has been regularly updated to reflect the new advancements in the field. There are two processes to become recognized as a Fully Certified Child and Youth Care Counsellor. 1. A person must have a degree or diploma in Child and Youth Care or have completed 2 years of study in the Bachelor of Child Studies Program from Mount Royal University with a letter of endorsement (this two year program was previously recognized as a Child and Youth Care Diploma Program until 2014) Candidates with a degree or diploma in child and youth care will be exempt from the exam process but not the endorsement and internship requirements. 2. The second process is for candidates who do not have a degree or diploma in child and youth care. The candidate must complete a 3 hour written and a 3 hour oral exam. The exams demonstrate their knowledge of theory and practice of Child and Youth Care and the integration of such into practice. All certification candidates must complete 2080 hours of internship, and be endorsed by their Agency. This process allows agencies to hire staff from a variety of backgrounds and leaves the agencies in control of the endorsement of certification.

In 2012, The Child and Youth Care Association of Alberta received a grant from the Alberta Government to develop an on-line education system. There are 3 levels of education. Level 1 focuses on providing practical skills and knowledge required by Child and Youth Care Counsellors. Level 2 provides the necessary information to assist with passing the written and oral exams of certification. Level 3 is for certified Child and Youth Care Counsellors which provides specialized and current knowledge. The online system ensures accessibility regardless of location.

The Child and Youth Care Association of Alberta applied for legislation under the Health Profession’s Act in 1990. This application was denied due to Child and Youth Care not being perceived as a health profession. However, in the past 34 years the field of Child and Youth Care has shown considerable progress. As part of this field, Child and Youth Care Counsellors are employed by Alberta Health Services, and our scope of practice does include restrictive procedures identified under the Government Organization’s Act. For example, Child and Youth Care Counsellors do administer and have a basic understanding of psychotropic medications and medications classified as narcotics. Child and Youth Care Counsellors do provide services and interventions to clients classified under persons with disabilities, disorders and mental health issues.

Guidelines – Becoming a Regulated Health Profession:

A) Ascertain what constitutes the practice of the profession, whether person’s practicing the profession should be authorized to provide restricted activities and the conditions, if any, that should apply to the practice of the profession or the provision of restricted activities.

The profession of Child and Youth Care has been in existence since the 1940s, and has had an Association in Alberta since 1971.

The client base is children, youth and families who are identified as ‘at risk/vulnerable’ by a variety of allied professionals, in social service settings, mental health programs, schools and communities. Typically, Child and Youth Care Counsellors work with children from five years of age to 18 years. However, when youth are in transition to adulthood the Child and Youth Care Counsellor will potentially maintain their services until a youth reaches the age of 21 and sometimes up to 24 years of age, depending on the service agreement and the agency’s policies.

The profession is orientated to provide mental, physical, emotional, and social health, and wellbeing, for children, youth and their families. The Child and Youth Care Counsellor is an aligned profession working in tandem with the Health Service industry and other identified professions under the Health Professions Act.

The health services provided by Child and Youth Care Counsellors are, but not limited to:

  • To protect, promote or maintain health, to prevent illness, treat or rehabilitate them to take care of the health needs of the ill, disabled and injured clients under the direction of medical personnel whom are not always present.
  • Recognition of developmental issues.
  • Teaching life and social skills.
  • An eclectic approach to complex mental, behavioral, and emotional health utilizing therapies and interventions such as:
  • Behavior Management
  • Milieu Therapy
  • Response Ability Pathways
  • Trauma Based Therapy
  • Solution Focus Therapy
  • Collaborative Problem Solving Approach
  • Complete suicide, self harm and aggression risk assessments and intervene accordingly knowing the profession’s limitations, and when appropriate make necessary referrals.
  • Recognition of mental health concerns and refers when appropriate.
  • Knowledge and providing appropriate intervention for DSMV diagnosed mental health issues.
  • Administering of prescribed medication(s), accounting for narcotics, and the administration of over the counter medications, when required.
  • Understanding medical diseases and or conditions and following medical direction for interventions.
  • Role modeling appropriate interventions and therapies.
  • Administration of basic first aid, such as sliver removal and cleaning of wounds, taking care of nosebleeds, contusions, cuts, allergic reactions and the like.
  • Assisting and teaching clients with activities of daily living such as washing, teeth brushing, basic self care, and how to identify something unusual such as a rash or lice.

Child and Youth Care Counsellors provide psycho-social interventions as the main method of creating change, with most work occurring in the living environment of the child, youth and family. Psycho–Social interventions are administered through therapeutic interventions.

Therapeutic interventions are required due to the dysfunctions, traumas, abuses, neglect, and or mental health related issues, the clientele experience.

The Government of Alberta, Government Organization Act provides the standards and directions for those practicing particular activities related to health services. Typically the activities the Child and Youth Care Counsellor provides fall under Schedule 7 of this act and include:

Schedule 7.1

Definitions

1 In this Schedule

(a) “activities of daily living” means an activity that individuals normally

perform on their own behalf to maintain their health and well-being and

include

(i)routine and invasive self–care activities, including but not restricted to the removal of slivers and cleaning of wound, and

(a.1) “administration of drug” means the supplying of a dose of a drug to a

person for the purpose of immediate ingestion, application, inhalation,

insertion, instillation or injection;

(e) “health services” means a service provided to people

(i) to protect, promote or maintain health,

(ii) to prevent illness,

(iii)to diagnose, treat or rehabilitate them, or

(iv) to take care of the health needs of the ill, disabled injured

or dying;

(p) to perform a psychosocial intervention with the exception of treating substantial disorders of thought, mood, perception, orientation or memory that grossly impair

(i) judgment,

(ii) behavior,

(iii) capacity to recognize reality, or

(iv) ability to meet the ordinary demands of life

B) Evaluate the risk to the physical and psychological health and safety of the public from incompetent, unethical, or impaired practice of the profession.

Incompetent, unethical or impaired practices increase the potential for serious acts of criminal violence. Malpractice has resulted in, much publicized, abuse/trauma of the public and clients. A portion of the client population are classified as a danger to themselves/others due to suicidal/homicidal tendencies. This would indicate the potential for serious consequences if professional interventions are not received. Educational standards and an enforceable code of ethics are essential to provide the treatment and effective services required by the clients.

Quality standards will protect the general public through the delivery of knowledgeable treatment interventions to the clients and their families. Leaving the care and treatment to uneducated care givers has resulted in further trauma and abuse of this vulnerable population.

When evaluating the risk it is important to note that Child and Youth Care Counsellors are predominantly supervised by other Child and Youth Care Counsellors. So if the supervisor is uneducated then effective interventions will not be modeled, taught or administered.

There is not only a potential for significant or negative consequences to an individual consumer’s physical health, but there are documented cases where individual consumer’s have died, been assaulted, abused or further traumatized.

Incompetent and unethical services provided by a non-regulated Child and Youth Care Counsellor can impair or lessen the quality, strength, or effectiveness of the required services. This then results in the deterioration, persistence or increase of original issues, leading to continued or greater personal suffering for the client, family and the community. This can also lead to new, more, or longer periods of reliance on, services being required. The extra services bring a significant increased financial strain on the family, community and province of Alberta.

C) Evaluate and make recommendations on the services normally provided by a person practicing the profession, including the complexity of the services and how they are carried out.

Child and Youth Care Counsellors provide health services by working with individual clients or with a group of clients either independently or as a member of a team.

Child and Youth Care Counsellors practice in a wide range of settings such as schools, hospitals, group homes, residential treatment centers, drug rehabilitation centres, juvenile correctional institutions, home-based care, community resource centres, sexual assault centres, and drop in centers.

In evaluating the services of the Child and Youth Care field, the Child and Youth Care Counsellor has, as their primary concern, the mental, emotional health and wellbeing of their clientele.

This field does assess behaviors (such as various risk assessments), but does not provide diagnosis of behavior, emotional and psychological disorders. The Child and Youth Care Counsellor will support the work of other professionals, such as psychologists, who may make recommendations for the implementation of a particular service plan.

A number of interventions and modalities are integral to Child and Youth Care Counsellor

practice. These include but are not limited to:

  • relational therapeutic child and youth care practice;
  • maintenance of a therapeutic environment/milieu;
  • life space intervention;
  • therapeutic crisis intervention;
  • suicide intervention;
  • developmental perspective;
  • non-abusive physical restraint;
  • resilience and developmental asset approach
  • systems approach;
  • family intervention
  • solution focus intervention
  • trauma based therapy
  • response ability pathways interventions
  • collaborative problem-solving approach

Clients are referred from a variety of sources. Referrals for services to Child and Youth Care Counsellors can be made from, but not limited to: social workers, psychologists, the school system, police, youth justice system, medical professionals and the community at large.

Within a system of care, interdisciplinary referrals are part of the on-going practice. An example of an interdisciplinary referral would be a teacher who may refer a student to a social worker who then may refer a client to a Child and Youth Care Counsellor. Child and Youth Care Counsellors also refer clients to other services in the community such as psychologists, recreational programs, and educational supports. After a client or family is referred for services the work of the interventions will be carried out by the Child and Youth Care Counsellor.

Child and Youth Care Counsellors frequently request and advocate for the clients they serve to be referred to other health professionals when appropriate or required, but do not make professional referrals as a whole. A Child and Youth Care Counsellor does make appointments for their clients to see other professionals such as but not limited to: psychologists, doctors, dentists, psychiatrists, social workers, therapists, and other health care professionals when appropriate.

It is recommended that due to the complex knowledge required by this field, it is imperative that Child and Youth Care Counsellors become legislated, to promote health, life skills, support growth and development, as well as, to protect the clients and public from further harm.