rsm92

Journal of Adolescent = Health and Welfare

Vo= lume 9 - No 2 - Special Issue 1996

Youth * 1986 - 1996 * Support

Tenth Anniversary Edit= ion



Letter from the ed= itor -

Dear Colleagues,

Well , I never thought we would actually get to the ten year landmark - but we did! Happy Birthday Youth Support!

In this edition of the Journal we are going t= o look back a little over the last ten years and recap what has been achieved and = what lessons we can learn from the past .. we are also looking to the future An exci= ting year lies ahead. ..!

Fund raising started well with the news that = we were allocated £20,000 from the National Lottery - this is earmarked = for improvements to the building at Crescent Road which we are currently purchasing. The third Charity ‘Dog Night’ at Catford Stadium on 30th May will hopefully raise money for our counselling centre a= t 3 High Street Penge - We now have three ‘shops’ in Penge - No 3 (counsellin= g); No 5 (workshop and sales); No 7 ‘Warm Fuzzies’ pet shop project.

Our reunion on 4th February brought together = the young mothers, their children and their families who formed the cohort of pregnant schoolgirls involved in our longitudinal study of teenage motherho= od. Many of their tales are told in “Are you my sister, Mummy?” and a n= ew publication will be available soon dealing with the long term follow up.     In planning the reunion I certainly underestimated the level of interest and the proportion= of young families who would be still in touch after 15 years.... we were snowed under!! Their stories are som= etimes encouraging - girls who have struggled with immense hardship to raise young families; sometimes tragic - young mums who died leaving= their parents to bring up their children; but always significant and moving. Many= thanks to all the families who are willing to give time and effort to remain invol= ved and provide us with important data to help the next generation of young gir= ls.

Again I want to remind you that our celebrati= on party will be on Friday 21st June 96 - midsummer day - which is exactly 10 years to the day when our first Youth Support event took place - the ‘Jamaica benefit’ fair. This time we will be having the ‘Blues Brothers Experience’ instead of Keith’s reggae sou= nd system .. and that the main scientific event of the year will be our day conference at the <= st1:place>Royal College of Physicians on 24th October. .. so the year sh= ould have something to cater for all tastes ... see you there!=

Best wishes and thanks for all your support throughout the years,

  &= nbsp;           Di= ana Birch

  &= nbsp;           Di= rector Youth Support

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YES!.... we reall= y did it - some of our young families

at 4th F= ebruary Reunion<= /span> <= /i>

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The fifteen year surve= y is a reality... Living proof that teenage mums can do it!!. Youth Support grew out of the work= with young parents - it is therefore fitting that we begin our Anniversary year = with a celebration of young families. All these young mums kept in touch, kept t= heir babies, made themselves happy homes for their children ... Congratulations!!

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The History of Youth Support

Youth Support was born in 1986 out = of a need to provide a service for teenagers and support to schoolgirl mothers and the first Y= outh Support publication on schoolgirl pregnancy “Are you my sister, Mummy?” came out in time for our first meeting. The statutory service= s - health , education and social services were not cateri= ng for this age group and there was a danger that the medical services particularly were dividing care into paediatrics - i.e. children’s services; and a= dult services with adolescents and young adults falling in the wasteland between. The first committee was a group of doctors, nurses and education and social work staff from the Lambeth and Southwark area of south London - bu= t we soon acquired colleagues from other parts of the country and further afield= .. by the time our Forum was started in 1987 we had= links with Bristol, Liverpool, Scotland and International members from Ireland, Sweden, France, Russia and Jamaica= . Later our international work took off in a big way and it would currently be impossib= le to fully list the countries we have links with or indeed the nationalities = of our workers.

The fi= rst Youth Support ‘event’ was the Jamaican benefit fair - held in the emp= ty grounds of disused St Giles Hospital - with bouncy castle, burger grill and Reggae sound system entertaining the locals. We didn’t earn much money but we sure had a good time! The event competed with Glastonbury festival on midsummer day 1986 - and it is for t= hat reason that our celebration party is being held on 21st June 1996<= span lang=3DEN-GB>. Jam= aica had just suffered severe flooding and there was a need for me= dical supplies and vaccine for the children.&nbs= p; We obtained one thousand doses of polio immunisation= from Burroughs Wellcome and antibiotics from Beecham which was sent direct to the ministry of healt= h in Kingston, Jamaica.

The ‘Gil= lick effect’ and the counter influence of ‘Schoolgirl Mum’ and ‘Too young..’ formed the basis of a presentation to the International symposium on Adolescent health in Austral= ia 1987. It was at this conference that the ‘International Association f= or Adolescent Health’ ( IAAH) was born and Yo= uth Support was at the forefront in promoting the cause of adolescent health internationally. Diana Birch (president elect ‘89-91) and Anne McCarthy were on the committee from the outset resigning in 1991.

On returning from Australia the ‘Youth Support Forum’ was formed to provide professional support for colleagues working with young people and at the first meeting at the Ro= yal Society of Medicine in September 87 we were joined by speakers - Paul Griffiths - who had just been setting up ‘Child Line’ and Fay Hutchinson from the Brook Advisory centres, Anne McCart= hy came over from Ireland and Daniel Hardoff provi= ded a perspective from Israel.

Eventually we discovered that one o= f the mother and baby homes catering for some of our pregnant schoolgirls was facing probable closure. We offered to take it ove= r and our first attempt in 1987 met with resistance; however by 1989 the home had been completely run down and was due to be boarded up until expiry of the lease. .. a clause in the lease stated that if a= group caring for young mothers was able to continue the work, then they should be given priority .. hence we were able to step in.= The landlords (the Church Moral Aid Association) were supportive and fortunatel= y did not demand a capital investment . we were allowed to take on the building on the strength of the reputation of t= he work with young parents.

Once we had the building .. plain sailing it was not! There follow= ed many months of lonely, cold , dirty work by a fa= ithful band of students and volunteers .. the house was filthy... anything of use had been removed .. somebody<= /span> had even swapped the relatively OK mattresses with soiled ones from an old people’s home. .... We dragged out all the rubbish ... cleaned painted and scrubbed. Renald an opera student from France, ‘PG’ an Italian Clarinettist and Gerry saxophonist from Ireland were the first ‘crew’. We sang as we = worked .. especially when ‘Mimi’ arr= ived who had a reputation for leaping on tables to add drama to her rendition of Carmen .... but there were times when Renald an= d I thought the end had come as we teetered perilously on the edge of the fire escape three floors up moving yet another wardrobe ... I hate wardrobes!! T= hen there was the time the cleaner and I got stuck to the floor after we tried = to remove three layers of carpet tiles stuck down with evostick .. or the t= ime that we were making one last run in the broken down van from the old ILEA furnit= ure warehouse in Tottenham, we limped along with failing lights .. an old lady collapsed on the Zebra crossing infront of us .. the ambul= ance strike was on and the police asked us to lay her out in the van!! The ‘coup de grace’ was perhaps the ‘crustacea nostra’ caper when it transpired that - unbeknown to us - the van had been used for a pickup of frozen shrimps from Gatwick airport .... the shr= imps were packed with cocaine .. imagine the scene ..= police raid .. helicopters = above .. it did get sorted!

There were housewarming parties .. we needed them to keep up our spirits!= The first was Halloween 1989 when we decided it would be good to have a treasure hunt by torch light .. a whole load of teenagers converged on the house dressed in fancy dress - witches, ghouls and a black cat that lost it’s tail. They followed a trail round the enormous empty old house in pairs .. not knowing that the Youth Support ‘crew’ = were hiding in the shadows dressed in black, rattling chains.. The screams were blood curdling .. the= best Halloween party ever. The casualty was a cleaning lady who walked out after= a hysterical outburst the following morning provoked by finding a dead snake = in her pail .. the lost = tail!

The second party was Guy Fawkes night - the 5th Nov= ember fires were great for disposing of the old mattresses and we invited all the neighbours so they would not complain. We ate baked potato and sausages by the l= ight of burning furniture and finished the evening with a ‘cot hurling’ contest. The soggy mattresses needed petrol to start them off - which nearly finished us off .. whoooom ... and somebody put the cheese for the= baked potatoes in the freezer so breaking it up was a hammer and chisel job. .. <= span class=3DGramE>there was actually something rather potent about that = cheese .. Sean made a fondue with the leftovers which blocked the sink ... even the Great Danes turned their = noses up at it.

The first items of furniture in the= house were donated or obtained cheaply second hand but some of the items were bou= ght with money raised by our first Catford charity = dog night - this raised just under £4,000 in October 1989 - it was so successful that we repeated the event in September 93 when we raised over £6,000 for our video assessment unit and we will be having a third ev= ent in May 1996 to raise money for our new counselling centre in Penge.

The Youth Support nursery opened in= March 1990 and the residential unit for teenage mothers received it’s first customer in June 1990 - the delay caused by registration quirks and t= he change in regulations. Daniella was number one = and Chloe our first baby, rapidly followed by Shirley and baby Emma and Maria w= ith baby Kevin. Morale was aided = by the supportive presence for six months of John Fricker from California who soon realised that even visiting professors carve the chicken when the cook freaks out! The cook’s untimely demise led to t= he ‘musical stand ins’ Operatic Renald= was a great cook but expensive .. = insisting on Gruyere rather than cheddar in his soufflé ... Campbell enthusias= tic but lethal and nearly ended his virtuoso Chellist career when he sliced a piece of thumb instead of the carrots! ...By the ti= me we had our ‘official opening’ in April 1991 we had six resident= s, mothers with babies; an alcohol and substance abuse programme; a flourishing nursery plus after s= chool children , professional teaching courses and outpatient therapy and educati= on was beginning to take off. The ‘opening’ was very successful wi= th a fete in the grounds, a little blessing service led by Canon Leslie Virgo at which the children held animal glove puppets and sang the St Francis song ‘brother Sun and sister Moon’;= ribbon cut by Roger Tonkin from Vancouve= r with Bouncy castle eminently blown up by Professor Richard McKenzie from Los Angeles. We were seeing the light at the end of the tunnel.

The advent of the Children’s = Act implemented on 14th October 1991 shut the light out for a while - almost permanently. We had a disturb= ed resident who provoked a riot when she thought the children’s act meant that ‘they can’t tell you what to do any more..’ and tha= t the rights of parents and young people were absolute. A great deal of furniture= and fittings were destroyed and the police did nothing to protect staff or prop= erty - later we did get an apology - they had miscalculated the affair - too late for us. The residents were expelled and we rebuilt and = redecorated .. it was hard but a skeleton staff pulle= d the unit up to scratch in a few months and we took in the first of the ‘n= ew batch’ in April 1992. This was when we extended the scope of the unit= and began the family work. Alex and her wonderful family were the first .. and they are doing= very well.

Since then our residential unit has= changed to cater for whole families and takes a wide age range - so many young mums= are not referred in the early stages now due to funding cut= s .. they are then sent several years along the line perhaps with a third child or toddlers who are giving her problems or when = the family is breaking down .. a short sighted refer= ral approach. The ‘treatment’ side of dealing with substance abuse and alcoholism= has become very important and we have catered for mothers with learning disabilities and a multitude of problems. Abuse, the se= quelae and the continuing problems for the family are a focus in many referrals. We have also taken as residents single young people who need therapy - particularly in the area of sexual abuse. There are many months now when we= are full to capacity and have a waiting list .. the ‘outreach work’ is also at full tilt a= nd we will soon have to open Youth Support Two. We have grown from a staff of a d= ozen people to over sixty people including five therapists - all due to the commitment of those early people.

We have had help from a number of s= ources - the Princes trust who gave us £2,0000 for a computer for the schoolroom - The Minet trust w= ho gave £3,000 for our first outreach programme and Barclay’s Bank= who gave £2,500 towards the new kitchen in the school room which allows t= he residents to run a lunch club for local elderly - a scheme designed to give youth the idea that they are useful to the community - can give something b= ack .. and it also has aspects of ‘adopt a gran’ for those without an extended family to r= elate to.

Although the Children’s act n= early brought about our downfall, it has currently proved to be a source of our succe= ss since the amount of court work has increased out of all proportion and this brings a great many assessment cases, some of which go on to rehabilitation. Life in the unit is different every day - excitement as when a disori= ented girl hovered on the window sill three floors up thinking she could fly .. or danger when one set fire to her room ... pleasure when children planted some flowers in the front garden for me ... embarrassment when they turned out t= o be stolen from the church next door ... pain when a young mother dies .. joy with each new baby and with each family able to wa= lk out of the door to a life together in the community.

Chronology of Youth Support

*Jamaica Benefit Fair*	*June 21st 1986*
*First liason with Women’s centre Jamaica*	*August 1986<= /o:p>*
*First Public meet= ing - Queen’s hotel Crystal Palace*	*October 1986=*
*Schoolgirl Mum - = BBC2 - Too Young to have a baby? BBC Schools TV*	*1986*
*Are you my sister= Mummy? - first edition*	*1987*
*Forum - and secon= d public meeting - Royal Society of Medicine*	*October 1987=*
*First liason with Soviet Union*	*December 1987*
*Glasgow Meeting -= Royal College Physicians & Surgeons of Glasgow*	*June 1988*
*Second London For= um meeting - Royal Society of Medicine*	*October 1988=*
*Crescent Road Bui= lding secured*	*September 1989*
*First Catford Dog Night*	*October 1989=*
*Third RSM meeting=*	*October 1989=*
*Guy Fawkes Party -*	*November 1989*
*New Year’s = Eve - First Russian’s arrive*	*31st Dec 1989*
*Nursery opens - R= osa joins staff*	*March 1990*
*First Residents -= Lynne joins staff*	*June 1990*
*First school trip= to USSR*	*June / July 1990<= o:p>*
*John Fricker joins us from USA*	*September 1990*
*Fifth Public meet= ing Celebration dinner- Royal Society of Medicine*	*October 1990=*
*Allied Dunbar don= ate grant for Baby Unit*	*January 1991=*
*Russian staff joi= n us - building of summer house*	*January 1991=*
*AIDS and Young Pe= ople conference*	*February 1991*
*Official opening = - Youth Support House*	*13th April 1991*
*Children’s = Act - riot*	*October 1991=*
First Lunch Club - Russian School Performance for Barclay’s Bank=	*December 1991*
*Retracing the Ech= oes*	*January 1992=*
*First family plac= ements*	*March 1992*
*Inner Worlds and = Outer Challenges*	*March 1993*
*Fire in flat - fa= mily unit redecorated and restructured*	*June 1993*
*Second Catford Dog night*	*September 1993*
*Opening of Video Assessment Unit*	*February 1994*
*Pet therapy - min= i farm*	*June 1994*
*Acquiring Warm Fuzzies Pet shop project*<= /p>	*August 1994<= /o:p>*
*Child Protection = and Family RSM Launch of “Bonds and Boundaries”=*	*October 1994=*
*Warm Fuzzies - Official opening by Mayor - Pet day*	*29th April 1995*
*Pet Club takes Ci= ty and Guilds exam in pet shop management*	*June 1995*
*Tenth RSM meeting= .*	*October 1995=*
*Lottery Money Gra= nt - development of premises*	*January 1996=*
*Young Parents reu= nion - 15 year survey.*	*4th February 1996=*
*Acquisition of ne= w shops in Penge - counselling and workshop*	*early 1996*
*Purchase of Cresc= ent Road premises*	*early 1996*
*Third Catford Dog night*	*May 30th 1996*
*Tenth Anniversary= Party - Blues Brothers Experience*	*21st June 1996*
*Adolescent Health Conference - Royal College of Physicians*	*October 24th 1996=*

Adolescent Health - A = Decade 0f Developments

In considering a review of adolesce= nt services over the ten years of Youth Support I draw on an article "Spe= cial Reports - The Health Status of Adolescents in Europe"= initially prepared for the International Journal of Paediatrics. During the late eighties and early nineties, I found it essential to visit the United States to catch up with developments in Adolescent medicine and was impressed at the way that Adolescent Medicine was in fact a recogni= sed speciality. It has recently become board certifiable and stands in it’s own right rather than as a subdivision of paediatrics.= A training programme has existed for a number of years and many of the Europe= an medical practitioners involved in adolescent care have spent time in one of= the North American ‘fellowships’.&= nbsp; In England I met resistance - my attempts at ‘teenage counselling’ within the health service met with mutterings of ‘= not cost effective’ and it was hard to explain that a doctor should have knowledge of social medicine, psychotherapy, addictions and behavioural problems ... as well as family planning, paediatrics and sexually transmitt= ed disease. Was I a psychiatrist , a health educato= r or what? I have been a member of the Society for Adolescent Medicine for a num= ber of years and regard the members as my ‘peer group’ whom I need = to meet with on a regular basis to recharge my professional batteries and real= ise I am not the only madwoman in the world!....

Adolescents throughout the world are confronted by similar problems and tasks involving psychosocial development, emerging sexuality and the challenges of risk taking behaviours. However the impact of these developmental stages on the health of the adolescent will v= ary tremendously depending on the cultural environment , accepted mores and soc= io economic status; still important, but on a lower key, are the variables introduced by health care and the professional input into preventive and educational medicine. On all these parameters Europe differs from the transatlantic scene and even within the continent there are large cross cultural variations.

Professional Care Providers

Firstly let us consider who works w= ith Adolescents. In Europe as in the USA there has been a debate regarding the appropriateness of paediatric versus adult physicians caring for adolescents and traditionally the trend has been for paediatric services to raise their upper age limits to encroach further on the 'teenage' market.

A questionnaire delivered to the pa= ediatric societies in most of the European states (Burgio; Ottolenghi 1994) demonstrated wide differences in adolescent care and guidelines. The authors were able to compare data from a similar enquiry made in 1975 which revealed that the upper age for remainin= g on a paediatric ward varied from 14 to 18 years (with the exception of Portugal where it was 10 years). France, Netherlands, Poland, Sweden and the United Kingdom had upper limits of 18 years although not long before the limit in England was 14. (Burgio GR, Lorini R, 1975) Cynics could argue that the increased range related more to the ri= se in the number of paediatricians who needed consultant positions rather than= the increase in concern over the provision of adolescent services.

Twenty years on, only 10 of the 29 respondent countries considered adolescent medicine to be= the province of the paediatrician and the authors concluded that "... It is often claime= d that adolescent care and assistance should be assigned to paediatricians who have followed children during their growth, are prepared to deal with growth and puberty problems, and are used to discussing with parents problems related = to school, sports and habits. There is serious doubt as to the extent to which this actually occurs." <= /span>

The situation in = Europe has paralleled t= he US arguments - the America= n Academy of paediatrics made a statement in 1972 that "The purvie= w of Paediatrics usually terminates by 21 years of age"= (American Academy of Paedia= trics 1972) but five years later did recognise Adolescent medicine as a speciality. In most European countries we have no recognised speciality of Adolescent Medicine - = Austria differs in recognising adolescent medicine skills since 1989. The arguments in Britain have circled several times around whether or not there should be a subspeci= alty and the British Paediatric association has held out firmly for the role of general paediatricians while acknowledging that "adolescents in hospit= al should be treated in adolescent wards." (BPA 1991) Many who actually work with young = people would argue that differing skills are required and I am reminded of the com= ment made by a past president of the Society for Adolescent medicine that ".. The time has come to eith= er 'paint or get off the ladder" (Sanders JM Jnr 1988).

The argument for an Adolescent Medi= cal speciality has been explored by several states including Norway (Noess PO. 1993) which has a very good record in terms= of health education and preventive work with young people. Similar arguments a= re put forward by the Germans who note that most adolescents do not wish to = be treated by a paediatrician, n= or do they seek treatment by "doctors for the elderly". .(Kurz ; = Borkenstein. 1991).&= nbsp; ".. Most of the complications or problems are specific for that= age period; they are not well known to all medical doctors. Because of these reasons, specialists in adolescent medicine are mandatory for proper treatment".

Another factor to consider, is something more banal - that despite all the training in the world, there= are those among us who just cannot work with young people. They may not like yo= ung people, they may find them provocative, challenging, threatening, they may = be embarrassed by them and the things they say and do. Working with youth, the professional has to be very open and honest - they see through half truths = and respond badly to being ‘fobbed off’. Many health workers are us= ed to letting patients down gently, protecting them from the stark truth .. they also like to = be ‘in control’ of information and of an interview ... all this do= es not go down well with youth. = There is therefore a sense in which attitude can be more important than training.= hence working in adolescent health is most definitely a ‘vocation’ in every sense of the word.

Services for Adolescents

The German view epitomises the wide= ly held outlook of those working with youth -in that general services are insufficient " ... a small proportion= of adolescents actually consult general practitioners. Inadequate co-operation between medical and&nb= sp; mental health care services as well as insufficient links bet= ween these services and the life of adolescents have led to a situation in which the use of professional assistance= meets with barriers. As a result, adolescents continue to avoid visiting a physic= ian even when they have already become ill." (Palenti= en C. Hurre= lmann K 1994)

There is a growing consensus that adolescents require services in their own right and that we are doing them a disservice if we feel that we can enter this field without specific training and without tailoring our services to the needs of young people. In Spain a questionnaire delivered to the Catalan Society of Paediatrics= Found that only 20% of the paediatricians had different schedules for adolescents than for children, onl= y 16% provided a separate waiting room and only 4.3% actually showed a preference= for dealing with adolescents. (Suris; Garcia-Tornel 1991) Major obstacles were perceived in provision of comprehensive care to teens including ".. not= having different schedules or waiting rooms, confidentiality, and the patient's perception of them as a "children's doctor."

So what services exist for adolescents? Services need to= be looked at on a variety of levels - the concept of the 'Adolescent Ward' or hospital unit is too narrow. = Adolescent medicine encompasses a wide variety of approaches from the inpatient acute services to health education and social medicine. Martin Fisher (New York) expressed his views regarding the status of Adolescent Medicine in the Unit= ed States on a visit to Youth Support “....Adolescent medicine takes on different perspectives depending on the area and the interest and expertise= of individuals. I was aware of that when I wrote an article in Archives of Dis= ease of Childhood on Adolescent medicine and it was brought home to me coming he= re and realising that none of the list of subjects which you had suggested your staff might like to hear me talk about were actually within my own practice= ! My perspective is more from the direction of adolescent inpatient units and hospitalised teenagers ....... In the = United States we have between 40 and 60 adolescent units where teenagers are hospitalised. They may attend for pulmonary disease, gastrointestinal disor= ders and are placed in the adolescent unit. Now the trend is for less hospitalisation, reduced numbers of beds and decreased = occupancy ...... In the USA we have developed a number of school based clinics= - the first were in 1980 in 3 places - Minnesota, Detroit and Dallas; by 1990 there were 200; by 1992 there were 400; 1994 we had 600 and so on - an exponential rise”.

Traditionally, in the United Kingdo= m the term 'Adolescent Unit' was used to describe adolescent Psychiatric units and the problems of teenagers were regarded as 'something you grew out of' and hence was not worth treating; 'something which was your fault' such as risk taking - and thus did not deserve treatment or 'something which your parents should control'. The acute illness was treated by general physicians or paediatricians, a few child psychiatrists bravely ran adolescent psychiatric units and the school doctor did routine physical checks on children most of which slipped throu= gh the net beyond the age of eleven.

Gradually various independent and charitable organisations began to set up teenage counselling clinics and sm= all services in various parts of the country - all tending to work in isolation= and 're inventing the wheel' main= ly based on provision of contraception and sexual counselling. One of the most important of these organisations was the Brook advisory service which for t= he last three decades has been opening young people's sexual advice centres throughout the UK and has been a major influence on sexual education. Another has been Youth Support, no= w ten years old, which is a charity providing services for teenagers and abuse victims which also runs a 'Forum' on Adolescent Health and Welfare which ar= ose out of the need for a professional peer group, co-ordination of ideas and support. There is now develop= ing a better understanding for adolescent care, the community health and school health services are responding to the need for more psychological and emoti= onal input and there has been wider recognition of the need for a multidisciplin= ary approach.

In France the first in patient adolescent unit was created in 1982 as part of the Department of paediatrics of the Hospital de Bicetre in Paris<= /st1:City>. (Alvin;= Courtecuisse 1991) This was based= on the American and Canadian experience and a multidisciplinary approach was u= sed with a good community network. Also in the eighties the Comite Francais pour l'Adolescence was formed. This took up the= brief of workin= g in the wider community and focused on health education and promotion produc= ing an excellent "Guide Sante" in 1987 un= der the leadership of Dr Sauveur Boukris. This health guide was widely distributed free of charge to adolescents.

The multidisciplinary approach has = also been emphasised in 'The Cholet Experience' (Jacquet; Mabrut 1991) whe= re a three tiered service was provided including the adolescent ward (5 beds) of= a paediatric unit (38 beds; 1,691 admissions). Follow-up was carried out in a specialised out-patient clinic (660 patients) held in an ordinary local apartment lent by the town-h= all. And a day hospital (12 beds) was reserved for those patients presenting with more severe psychological problems. In fact two thirds of patients presente= d with psychologi= cal problems, of which 40% were suicide attempts. This approach allowed the tea= m to function in a multifocal,multidisc= iplinary way while responding to local needs and providing a more global management and better follow-up of adolescents. ‘Creative’ approaches such as these provide accept= able environments for young people whose access to traditional clinics can be limited by stereotyped views and roles.

Specific Presentations

There is a sense in which those professionals who look for a problem will find it, and thus the type of presentation at youth clinics and counselling centres will fall in with the special interests and expertise of the workers. Hence clinics whose personn= el have an interest in eating disorder will not only recognise and diagnose mo= re, but also patients will be referred and tend to ‘gravitate’ in t= hat direction. It is thus difficu= lt to accurately estimate which ‘problems’ are of most interest and importance to youth themselves and which presentations are most honed in on= by the professionals. There is also a danger that a type of problem will be ‘legitimised’ by providing the sort of specialist centres which= we often see in Europe i.e. Brook for sexuality;; Samaritans for suicidal feelings; drug advice centres etc. rather than general counselling. This may lead to the situation for instance when a young girl hears the message that= she needs to be seen to be sexually active, or suicidal to be counselled, rather than just unhappy or confused. Nevertheless two broad areas would seem to be responsible for the majority of consultations across centres - emotional problems including sui= cide attempts; and the area of sexual health. These deserve special mention.

Mental Health and Suicide

Suicide has now become the second m= ost important cause of adolescent deaths in most of Europe. Rates have been gradually increasing and the UK has about the worst record in Europe with regard to young men. It has been suggested that this correlates with young male unemployment (Pritchard 1992). Certainly young people who are lacking in direction with no prospects of employment may fall into various types of self destructive lifestyles and we have seen a great = deal of unhappiness between young couples who get on each others nerves by having the man constantly at home under the woman’s feet, while he feels unfulfilled and emasculated by job loss and can perhaps attempt to regain h= is ‘potency’ by domestic violence or self harm.

In Britain about 1 in 20,000 young people actually die while 1 in 200 make a serious s= elf injuring attempt. These numbers hide the real depth of unhappiness since as many as 1 in 20 will admit to serious suicidal thoughts. Young mothers also have a high rate of depression which often goes untreated. One of our early Youth Support Forum meetings focused on teenage suicide with a presentation= by Eric Taylor who made the point that rises in youth suicide and parasuicide have occurred at a time when adult rates = were falling, indicating that our support services for depressed and hurt young people have been sadly lacking. Many have been victims of abuse and have be= en through part of the ‘care system’ hence early identification and intervention could have been a possibility, often the stigma and fear of suicide obstructs management of treatment.

The French experience is similar “.= . most come from troubled or abusive environments,= most did not clearly intend to die and are asking for some help. Only a minority appear= to be mentally ill and need inpatient psychiatric care. These patients are = best approached when hospitalised like any other adolescent and offered a thorough health scre= ening, within an integrated and multidisciplinary framework which allows working with both the patie= nt and his family” (Alvin 1993)

Sexual health and Education

This is always a ‘target̵= 7; area for professionals working with young people. It is important to maintain an overview of sexuality and sexual health - so often the field is dominated by the ‘politics’ of medicine - i.e. is there more funding in HIV prevention, or government propaganda on cutting teenage pregnancies, instead of looking at the needs of the individual young people.

Europe has a mixed reputation so far as sexual education and teenage pregnancies are concerned. Generally speaking northern Europe has a better tra= ck record than the southern states; the Scandinavian countries have had a successful approach to sexuality and have kept their teenage pregnancy rates low while Denmark<= /span> and Holland have the lowest conception rates linked to a very open and fr= ank approach to health education. The Dutch lesson has been admired in <= st1:country-region>Britain but sadly we have had a considerable opposition to the provision of good sex education programmes and contraceptive services for youth which led to decreased contraceptive use and increased pregnancies in the eighties. Our conception rate is thus the highest in Europe although trends in the nineties have been encouraging. Concep= tion rates for the under sixteen year olds were 10.1 in 1990; 9.3 in 1991 and 8.5 (per thousand) in 1992 the lowest rate since 1983.

Sadly the youngest age groups are least affected by contracept= ive availability and thus a significant number of 14 year olds and younger give birth each year. The under 14s have the worst prognosis in terms of personal outcomes and child rearing. The remaining girls have abortions and although= 60% of under 14 year olds abort their pregnancies ma= ny do so at a dangerously late stage. Only 23% of abortions to under 16s are performed before 10 weeks and 5% are performed after 20 we= eks. These girls often present late for care due to lack of sexual education and advice (Birch 1992).

Europe’s demography and political geography has changed radica= lly over the last decade - states have merged (the Germani= es); others have split (the former Yugoslavia and Czeckoslovakia) and the ̵= 6;new Europe’ includes = areas of the former USSR. Sexual education is in it’s= infancy here and there are enormous difficulties in achieving 'modern' standards. “The availability and use of mod= ern contraceptives is low; .... <= span class=3DGramE>traditional methods predominate .. it is c= lear that the level of induced abortion is higher in the USSR than in any other country in the world." (Popov 1991). Our work in the Urals and with Ru= ssian youth has highlighted the difficulties faced by teenagers exposed to the ‘western imports’ of prostitution, sexual promiscuity, drug abu= se and HIV. ..... A generation of youth is attempting to enter the twenty first century at break neck speed without the protection of health education and the le= vels of preventive medicine which most of us take very much for granted.<= /p>

References -

1. <= /span>Burgio G= R. Ottolenghi A. "Adolescence and paediatrics in Europe" European Journal of Paediatrics 153(10):706-11 1994 Oct.

2. <= /span>Burgio G= R, Lorini R, 1975 "= Sauver l'Unite' de la Pediatrie. Une enquete sur l'hospitalisation et l'ens= eignement en Europe" Archives Francoises Paediatrie 32: 893-900

3. <= /span>American Academy of Paediatrics, Council on Child and Adolesce= nt health , "Age limits of Paediatrics" Paediatrics 1972: 49:463

4. <= /span>Welfare of ChildrenYoung People in Hospital Department of Health 1991 British Paediatric Association HMSO London pp 21-23

5. <= /span>Sanders JM Jnr "Health Care d= elivery to adolescents and young adults by paediatricians” Paediatrics 1988;82:516-517

6. <= /span>Noess PO= . "Do we need a specialty of adolescent medicine in Norway?" Tidsskrift Den Norske Laegeforening113= (2):169-70, 93.

7. <= /span>Kurz R.<= span style=3D'mso-spacerun:yes'> Borkenstein M. "The responsibility of medicine in adolescence" Padiatrie und Padologie. 26(3):121-4, 1991.

8. <= /span>Palentien C. Hurrelmann K. "Adaptation of medical care to the changing disease spectrum of adolescents<= /span>" Gesundheitswesen.56(10):537-42, 1994 Oct.

9. <= /span>Suris Granell JC. Garcia-Tornel= S. "Adolescent medicine among paediatricians in Catalonia." Jour Adol Health. 12(6):430-3, 1991 Sep= .

10.Alvin P. Courtecuisse V."Adolescent<= /span> medicine Development and prospects”. Archives Fr= ancaises de Pediatrie. 48(2):137-41, 1991.

11.= Boukris S. "Guide Sante" Comite Francais pour l'Adolescence Rue de la Chapelle= Paris 1987

12.= Jacquet Y. Mabrut JP. "Multi-disciplinary approach to adolescents with problems. The Cholet= experience" Archives <= span class=3DSpellE>Francaises de Pediatrie.<= span style=3D'mso-spacerun:yes'> 48(3):179-83, 1991 Mar.

13.Pritchard C. “Is there a link between suicide in young men and unemployment? A comparison of= the UK with other European Community Countries.” Brit Jour of Psych160:750-6, 1992 =

14.Alvin P."Suicidal adolescents: lessons to be learned from early intervention." Jour Paed & Child Health. 29 Suppl 1:S20-4, 1993.

15.Birch DML “Are = You My Sister, Mummy?” Youth Support Publ ISBN 1 870717 02 3

16.= Popov AA." Family planning and induced abortion in the USSR: b= asic health and demographic characteristics." Studies in Family Planning. 22(6):368-77, 1991 Nov-Dec.=

Each year in En= gland and Wales approximately 10,000 schoolgirls become pregnant. Many of these girls will do well with their babies as evidenc= ed in our fifteen year follow up data - nevertheless for those who experience difficulties, it can be depressing to see the cycle repeated in future generations - ‘old girls’ returning to a residential unit to vi= sit their daughters and nieces in the next loop of the spiral. Conception rates have altered disproportionately so that the youngest girls now constitute a higher proportion of the number of school age births than previously indica= ting that the very young, most vulnerable, girls needing most support are being failed by preventive and educational programmes.

Why is this? Why do so many young girls become pregnant and so many young boys become baby fathers? An adult professional stance can lead us to fail to understand the difficulty that our teenage patients are confronted with in growing up; attempting to look at some of the conflicts from the young person’s p= oint of view we are more able to act practically and effectively to help our you= ng patients avoid making the same mistakes that we did at their age. By understanding the belief systems of the adolescent and his or her peer grou= p we can interact with that young person in a way which has relevance and meanin= g.

It is for this reason that the emph= asis of work = at Youth support is on emotional and motivational aspects of sexuality - beliefs, se= lf concepts and most particularly self worth. We must be forgiven some element= of repetitiveness in describing these concepts and their significance since the same basic principles influence so much of the adolescent’s behaviour= and thinking patterns.

Peer group beli= efs “You can’t get pregnant standing up” can be confronted with factual knowledge -sperm= can swim uphill! But at a deeper level are what I wo= uld describe as magical beliefs.Intrinsic ideas wit= h high emotional content a feeling of instinct and intuition which may have no perceivable basis in current reality. Magical beliefs centre on fundamental concepts; feelings about self,= body,control - the nature = of life itself.

The adolescent is much preoccupied = with the question “Who am I?” Confusion arises when “Who am I?” becomes “Who are we?” Acquiring a personal identity becomes a monumental task for a pregnant girl whose identity changes beyond her control; no longer a little girl, but a fertile woman. The role of mother is thrust upon her before she establishes her own identity, hence the belief that she cannot get pregnant= and denial of pregnancy. “I knew = how girls get pregnant, but never thought it could happen to me”

Girls deny that they can become pre= gnant. They believe they are too young. Belief in the impossibility of pregnancy t= ends to become almost a magical protection like a lucky char= m “It won’t happe= n to me”. These teenagers ar= e at the stage of concrete reasoning unable to identify with the experiences= of others. This explains why health education methods based on shock tactics do not work with this age group.<= /o:p>

Teenage sexuality is profoundly aff= ected by beliefs about control. Emotional development involves i= nternalising the “locus of control”, as= suming responsibility for one’s actions and one’s body. Those maintaining an external locu= s of control are not in control of when they have sex or whether they get pregna= nt, are not responsible for their actions or their bodies - pregnancy is someth= ing that happens to them. It is a m= atter of fate. An unplanned pregnan= cy represents the ultimate loss of control. Even their bodies are acting independently with their wishes. Belief in the autonomous womb explains why teenagers do not believe sex will result in pregnancy. It also explains som= e of the denial.

Belief systems<= span style=3D'mso-spacerun:yes'> interact in limiting contraceptive use. Hence for young teenagers under the age of 16, it is not s= o much a matter of availability of contraceptive services which affects sexual pract= ices and conception rates. Much more important is the social situation and life experiences which affect their emotional maturity, motivation and their val= ue systems. A self esteem measure<= /span> of pregnant schoolgirls and a comparable group of schoolgirl mothers indica= ted that while painful life experiences and deprivation resulted in an expected fall in se= lf esteem scores, the girls who were pregnant at the time of the testing felt = much more positive about themselves than the schoolgirl mothers. Pregnancy seeme= d to have protective value in conserving self-worth. Girls were finding an alternative value system by which to judge their lives.

Seen from a young girl’s view= point, pregnancy may not be so undesirable; motherhood is a fulfilment; she takes = on a valued role and out of her loveless world creates a baby who will love her. Pregnancy is thus used as a source of self-worth and a false solution to problems. That being so, an alternative solution must be offered. These young people need an alternative source of self-worth in order to ensure that when they become parents this is because they desire parenthood, with all its responsibilities, hardships and joys, not merely as the only perceived esca= pe from a catalogue of problems.

&= nbsp; Mobile= - Josie

&= nbsp; F1= 50295F 12a

Working at Youth Suppor= t

Student placement at Youth Support House

My = name is Annette Rattray and I am a student at Kingst= on University, studying for a Diploma in Social Work. My final practice placement is at = Youth Support House where I have been for the past four months. My work at the Univers= ity covered social work theories, social administration and the family e.g. fam= ily dysfunction, the Children Act 1989 and court procedures. However, having theoretical understanding of these gave me no concept of the practicalities and how to apply theory to practice. Bei= ng at Youth Support House has given me the opportunity to put this theory into practice.

I h= ave attended and taken part in placement reviews and meetings, visited various statutory organisations, attended prebirth and = child protection conferences and liaised with other professionals. I had the experience for the first time of accompanying clie= nts to the High Court, observed contact meetings between parent and child, sat = in on assessments and taken part in different therapy sessions.

The experiences gained while have been at Youth Support House i.e. group work, working with adolescents, young mothers and their babies and young families= have helped me to enhance old skills whilst learning many new skills. = For example, having a better understanding of parenting skills, low self-esteem= or lack of self confidence. I have learnt to have a better understandin= g of the clients feelings, how powerless they feel be= ing involved with social services, the family dynamics relating to the Children= Act 1989 and the processes. I feel tha= t the learning experience and knowledge I have acquired has developed me professionally, giving me a better understanding and insight as to what it means to be a social worker. I hope other students will be given the opportunity to do their placement at Youth Support House - it is an archive= of learning experiences.

Florrie= Lamptey - Social worker / Care worker

Dur= ing the process of accomplishing a CQSW certification my first year placement w= as at Youth Support House for a six month duration. During this period, I was inspired and enlightened by the areas of social w= ork. My role was to be investment towards developing future academic learning - through this I have gained a good working knowledge of children and familie= s.

Now= I have returned to Youth Support House as a qualified social worker my role i= s to liaise with outside agencies discussing casewor= k with other professionals including social workers, guardian ad litems, doctors, health visitors etc. in order to advocate effectively on behalf of= our clients recording and reporting in written form the progress of each family= .

Wor= king in a residential setting I believe it is necessary to reflect a professional attitude towards the residents.This I am able to demonstrate in line with the spirit of the Childrens Act 1989 by working in partnership and empowering residents within the unit= .

Oft= en very contentious decisions had to be made as a result of Child Protection conferences. I have become aware of various forms of abuse that many of our children have been subjected to - many of the residents have children who a= re looked after by the social services under the Children’s Act. Many of= our clients are from different ethnic groups some of which are classified as ha= ving special needs. These have taken the shape of learning difficulties and disturbed women and men. At times the responsibilities were stressful as decisions were made against the clients wishes a= nd feelings. I found the use of supervision an opportunity to debrief and air concerns. The added guidance also offered me the opportunity to gain direct= ions as well as developing new ways of working.

To = summarise, I have to acknowledge that, at the end of any day, the benefit and usage of= all the interpersonal skills of various levels of staff and team efforts with t= he young residents of Youth Support House can be very rewarding.

Priya Kanthan - Teacher

I a= m the teacher of the Youth Support nursery. I joined the team five years ago and since then the house and nursery have grown in terms of number of staff and facilities available. My main= job is to teach the nursery children at the pre-school level. I have also been involved in teaching young teenage residents and their children. I work eve= ry morning from 9 to 12 five days a week. Children attend the pre-school progr= amme when they are three years of age, learning their alphabet, numbers, colours, shapes, sizes and weights. Th= ey are introduced to situations that require concentration, patience, group activi= ty and discipline. Children look forward to their time in the schoolroom becau= se they are then classed as BIG children. They acquire pencil control and eye-= hand co ordination too. By the tim= e they leave the nursery to go to school the children are acclimatised to the idea= of schoolwork. Due to the happy structured disciplined environment here they f= ind it easy to adjust to a new school.

Cer= tain children need extra help with speech, writing skills, fine motor skills etc. Due to our small group emphasis on a one-to-one basis I can identify any problems and help solve them. I work with children according to their abilities and interests and emphasise group activities and projects.This enables them= to work together in peace and develop important values of sharing togetherness= .

Par= ents are involved in the progress of their children - work is sent home weekly a= nd regular meetings are organised for detailed discussions.

Reg= arding my work with the residents, I have helped many teenage mothers or pregnant girls with reading, maths, sewing and crafts and given lessons to some resi= dent children here with their families who, for various reasons, are unable to attend school. On the w= hole my work experience in Youth Support House has been varied and exciting - a valuable learning experience.

Pru Roche - Baby unit=

At = Youth Support House baby unit we operate a service giving professional advice in a caring, consistent manner throughout our clients’= ;assessments whether it be 24 hours close supervision in the case of child abuse or gene= ral care.This is done in a relaxed, happy atmosphere - ye= s, even when we have five or six babies suddenly needing feeds at once - consi= stent teamwork. Given the nature an= d ages of some clients it can sometimes be volatile but any major clash about to happen is quickly quelled; happily the most we get is “whose nicked my baby’s bottle/ vest etc” - mass manufacturing sometimes has a l= ot to answer for! Ou= r work as a team monitors bonding hands-on care, safety, stimulation and every oth= er aspect which enables the parent or parents and child to be a family. I have made light of our work which involves liaison with various carers, health visitors, doctors, physios,= ...... But our work in the baby unit is anything but light, and rewards are small. They often come from the strangest place such as young resident new mums wanting a cuddle from their own mothers but settling for second-best, a cud= dle from baby unit staff.

Clare Hann - Nursery= Nurse

When first asked to write a report my mind drew a blank - not because of lack of= day to day happenings which fill it, exactly the opposite! My title may be “Nursery Nurse” but I find myself in many other roles from day to day including escort, social worker, befriender - this is what makes my job so interesting.

Usu= ally I am knee high in children, lost in their wants and whys, sitting back occasionally to enjoy the amusing vocabulary or intense interactions between the 2-5 year olds.Whilst doing so, never forget= ting these early years are the foundations on which their future lives will be built. Our days in the nurser= y are always busy and varied. We could be off to the swimming baths, the library,= Warm Fuzzies pet shop, the park, firestation or even having an organised water fight!

As = the Youth Support nursery is smaller in size and numbers than most other day nurseries every child is able to express themselves individually and is tre= ated as such. We also have the added advantage of a mini-farm next to our playground, a sports instructor who takes the children for sessions and a teacher who takes the older and younger children in turn for basic pre-scho= ol teaching within our schoolroom.

Lea= ving the nursery children behind, I step into another scenario altogether - that= of older children holding tiny babies or families desperately trying to fit the pieces into the slots where society is requiring them to go. Caring for babies and toddle= rs within our baby unit is enjoyable though not without stress - there is a lot that goes with the actual caring; for example, encouraging parents to actua= lly come into the unit to be with their child, supervising sometimes unwilling parents in the care of children, observing the comings and goings of reside= nts. Last, but most important, keeping the welfare and safety of all the childre= n in our care first and foremost.

I h= ave been at Youth Support for several months and can honestly say that I have n= ever worked anywhere quite like it. Every day is different, and every day I come away a little wiser than the day before.&n= bsp; A lot is involved in the care and support of adolescents and familie= s in need. There is still a lot for me to learn, so for now I am just taking it = one day at a time.......

I will make an assumption that ever= yone here understands that for a child to grow into a reasonably controlled and confident person it needs to grow up in an environment where it feels safe, secure, loved and allowed to be. Given the strains and stresses of life, particularly in the case of single mothers knowing the value of play and gi= ving space for it the mother can both assist development of her child and enhance their relationship. I see my role at YSH therefore as facilitating that relationship.Most mothers who came to YSH, owing to t= he nature of their placement already feel inadedquate mothers. It is my job to try and support the mother and enable her and her child to feel relaxed and enjoy being together. Of course one paradox is how can a mother possibly feel relaxed knowing that she is= being observed and has an observer (me) in the room watching her. It is necessary= for me to establish a good relationship - a working relationship with the mothe= r. The mother will be my main point of contact, I don’t want to be ideal= ised by the child nor for themother to feel in competeition with me, thus leaving her feeling yet ag= ain undermined. Depending upon the age of the child, the sessions are structured around various toys and playthings. I encourage the mother to play alongside her child, this can be very complex as much depends on themothers own childhood and the experiences in life as to how freely she is able to p= lay.

The session can be one of teaching = mums how to play and supporting them in what they do well. The aim is to let the chi= ld lead the session which will increase the child’s self confidence choo= sing whatever she wants to play with and the mother engaging and playing alongsi= de the child whilst maintaining appropriate boundaries. If a child starts stic= king his fingers in electric sockets then the mother needs to each him that can = be dangerous for example. I said alongside and encouraging because one essenti= al ingredient of child development is to be mirrored. Mirroring entails reflec= ting back to the child so that his sense of self grows.This= can take very simple forms of smiling, repeating, sounds words, observing h= is play and reflecting it back in the form of words “I notice how carefu= lly you are drawing that cat” etc. Praising the child for what it does and letting a child persist in her own activity and not losing tolerance or sho= wing a child how to do things properly. In the world of play there are no right = or wrong ways of doing this - mistakes need to be made, mess needs to be made = and tolerated, his sense of self needs to be discovered and that requires toler= ance and support. For example, he cant paint on walls= but he can paint on this bit of paper - offering an alternative so the child wo= nt feel neglected.

I am reluctant to do too much teach= ing and prefer to draw out the positives and not tell a mother what she cannot do b= ut I had an example of one mother who in the first session just sat in a chair a= nd didn’t move, whilst her child ran around the room picking up certain objects and asking the mother what they were. The same happened in the seco= nd session so I decided to ask the mother if she had been taught or allowed to play and would it be helpful if I demonstrated some play for ten minutes? I did so, the mother joined in and I slowly withdrew. After six weeks the mother went from structured play to being abl= e to play imaginatively alongside her child.

Regarding very small babies of a fe= w weeks; structured play through toys is not always appropriate or necessary but patterns of behaviour and ways of being with each other can start here. Muc= h of what I do is allowing space for mother to enjoy just being with, holding, f= eeding, talking to and smiling at her child and in these seemingly ordinary actions= a lot can be going on.

Mother, father = and baby of a few weeks. At first father held the b= aby in his lap with the head cupped in his hands which were resting just above his knees and baby’s feet rested on fathers st= omach Father was looking into baby’s face. Baby seemed content and enjoyed = this and when baby had had enough of the fathers stare he averted his eyes and looked at the wall behind father. This continued for a while and mother took over. My instinct was that she felt herself a bad mother. She repeated how = the baby had started to smile at her - she bounced the baby gently I think hopi= ng to make it smile; it didn’t and the mother went further by trying to = push the corners of his mouth physically. More bouncing, and the baby started to object by crying and waving his arms and legs around. Hence the pattern. Invasive mother who is rejected by baby which increases her already low self esteem,= and in turn causes jealousy, anger competition between parents. Father thinks he is superior and mother is bad

My job would be to somehow change this pattern and if done well could change the whole family dynamic. I have attempted to give a flavour of my role, understanding the complexity of the parent - infant relationship; and each family needs t= o be handled differently and with much care.

&n= bsp; Fam= ily Work Advert

- Youth Support - Conc= epts in Nurturing -

The Lunch Club

<= /span>

When= you have been brought up in care or have been separated from your natural parents, t= wo factors result - first you do not have a well developed sense of ‘family’ and particularly miss out on the extended family. Not = only does this mean you do not experience the support of a grandmother or grandfather - but you have very little experience of talking to ‘old people’. One of our residents was actually afraid of talking to the o= ld and had to steel herself for this ‘practice’ situation.<= /p>

The = second thing is that when you have been in care or looked after by ‘the system’ all your life, you are used to things being provided for you - pocket money, clothing allowance ... ask your social worker for things ... = you thus are unable to develop a pride in getting things for yourself, working = for material goals .. and at the same time you are deprived of the ability to care for others and be valued by others.<= /p>

The = lunch club gives young people the opportunity to ‘give something back’ to = do something for someone else, to befriend someone that needs you .. someone outside ‘the system̵= 7;. We therefore have a group of elderly local residents calling in for lunch every Wednesday and being cooked for and waited upon by the resident young people. ... of course some of our ‘old folk’ are not that destitute and needy = .. but in coming they also feel fulfilled and they are al= so providing a service - hence we have winners all round!

The = lunch club was opened during a visit from a group of = Russian School children who sang, danced and generally entertained our first set of diners= - the event even got us publicity in the local press!!

The = same concept of becoming valued as someone who can contribute to society, has been operating in the pet shop project. .....

- Youth Support - Concepts in Nurturing - <= /o:p>

“Warm Fuzzies&= #8221; and “Animal Therapy”

The = ‘pet shop project’ has been described in past journals and I reproduce som= e of that description below for those unfamiliar with our project.... One of the spin offs has bee= n that groups intermingle and provide added ‘feedback’ to each other in unpredicted ways. For example when Jackie, one of the learning disabled you= ng women spending time in the shop became depressed and started to cry .... one of our ex resi= dents who was working there supported her and comforted her. She did a very good job and was pr= aised for her intervention - and when told by Jackie’s social worker that s= he was probably being manipulative ... the social worker was firmly given a pi= ece of her mind! R= 20;All she needs is for someone to talk to her, someone to care and listen .. you can’t ignore someone who is = upset .. even if she does want attention!” .. she spo= ke from experience and from the heart!

R= 16;Animal Therapy’ is very much in = at Youth Support. Ducks, Chickens, Rabbits and even a pig = figure as ‘staff members’. Many of our abused patients relate better to animals than to fellow human beings, they trust animals and feel needed when a young animal is totally dependant on them for survival. One a= ngry young man was released from custody to come to us. His ‘fury’ m= ight still have been felt towards society but his furry charges never realised t= he depth of his hurt and anger as he hand reared a litter of rabbits abandoned= by their mother. A fourteen year old girl kept three orphaned babies inside her blouse so that they could hear her heart beat and not feel alone ... they survived against= the odds. Many of our youth survi= ve against the odds ... they have often been pushed from pillar to post and be= en to several residential placements before coming to us, they have been abuse= d in their families, rejected by carers and further harmed by ‘the system&= #8217;. Kate keeps herself busy in our pet= shop or tidying up the mini farm while Betsy the Vietnamese pig keeps her mind o= ff drugs by chewing her shoe laces. The younger children learn how to groom the Chinchillas and let the Hamsters and Fancy rats run up their arms. Imagine the delight of our city = kids when Henrietta laid us her first eggs!

Our = Animal therapists do group work as well as individual therapy - with every group member having a therapist sitting on their lap. We have even brought them i= nto the staff group and revised Bowlby’s work= by looking at attachment in animals! Self Esteem is something they are good at= - lots of non conditional positive regard! Stroking a warm cuddly bundle is an excellent stress reducing activity for someone who has just been screaming = down the phone at their social worker or trashed their room in a frustrated rage= .

The = success of our ‘mini farm’ and Animal Therapy led Youth Support to expand the animal theme into a pet shop. This project gives more scope for the concept= of animal strokes and also provides the forum for a great many other activitie= s. Young people can do work experience and have lessons in accounting, ecology, animal care, stock taking and ordering, window dressing etc. and also have a craft session producing items which can be sold. There is a children’s corner and petting area, sand pit complete with dinosaur models and the ter= rapins swim in a Fred Flintstone tank.. Our rabbits and= fuzzy friends must be the tamest in Europe .. they are stroked and groomed almost non stop by our yo= ung customers who are encouraged to stay as long as they like - no purchase required!=

Clau= de Steiner, a disciple of Eric Berne and one of the early transactional analys= is therapists, wrote the original ‘Warm Fuzzy Tale” with the theme= of strokes being given freely and unconditionally in the form of warm fuzzy creatures. We thus named our shop project “Warm = Fuzzies”. Part of the project plan was to invite groups of children, youth with disabilities and the local autism group for example to visit and enjoy the animals - we did not plan one of the most valuable aspects of “Warm <= span class=3DSpellE>Fuzzies” - the refuge. Without any prompting or invitation a group of deprived children have made it their special refuge, they wait for us to open up and stay oft= en until closing time, doing anything they can to help, but mainly wanting to = get warm and safe and sometimes talk about their problems.= in a way which they may never do elsewhere - they trust the animals, we look a= fter the animals with them, so they trust us.&n= bsp; “Warm Fuzzies” is bringing a little bit of warmth, love and safety into the lives of London Youth.

Youth Support Tenth Anniversary Dinner

The Royal= College of Physicians

St Andrew= ’s Place, Regent’s Park London

Thursday = 24th October 1996 7pm

&nbs= p;

This follows our conference - b= ut please note that attendance at the conference is not a prerequisite for tho= se attending the dinner or the keynote lecture at 5.30pm - We very much welcome those who can only attend in the evening - tickets for dinner £25 from Youth Support

The Journ= al of Adolescent Health and Welfare

is publishe= d by:-

Youth Sup= port

13, Cresc= ent Road, London BR3 2NF

Charity N= o 296080