Podcast Transcript: Implementing the CARE Model

Bill Martin is the executive director of the Waterford Country School, a Connecticut youth shelter that will soon finish the three-year implementation of the CARE Model. He talks about why this particular evidence-based practice has allowed Waterford to better serve young people.

Time: 4:51 | Size: 4.44 MB

NCFY: Welcome to Voices from the Field, a podcast series from the Family and Youth Services Bureau. Today we talk to Bill Martin, executive director of Waterford Country School, a youth shelter in Connecticut. His staff has nearly finished the three-year implementation process for the CARE model, an evidence-based milieu treatment that challenges program staff to reorient their work around helping young people develop healthier relationships. 

Martin says they chose CARE over other treatment models because it was collaborative rather than prescriptive. Trainers guide a program’s work using a set of core principles that guide priorities and foster supportive relationships between staff and youth. 

BILL MARTIN: In other models that we looked at, it puts you in a position where you had to discard some of what you liked and other stuff and select that model over it. CARE is a trauma-informed model, but it doesn’t define what sort of trauma theory approach you want to take. It leaves that open. 

So CARE enabled us to bring in everything that we thought was helpful and everything that we’ve learned that we really like and fit it under this global structure of the six principles. And it was really nice Because it was sort of a place for everything that we liked, and yet a common language that drew it all together. 

Kids change based upon them believing in themselves, them having a connection with an adult who supports that change and will work with them through it, them having the skills and resources to do it. Not through adversives or consequences or behavioral incentives or the kind of things that we more typically did. It really is about a relational approach. It’s about co‑regulation, about staff and kids connecting as partners as opposed to staff regulating kids. 

NCFY: The CARE model originated at Cornell University with the intent of bringing together all available research into working with youth in crisis. Martin says Waterford has benefited from the staff’s new evidence-based approach. Though their CARE partners also leave room for them to define success with each individual youth. 

BILL MARTIN: The CARE model was built on the latest research in change theory. And really it kind of got us to a point where we started to realize that a lot of the things that we had done historically not only weren’t helpful, but maybe became part of the problem.

For example, so much was studied and worked with around behavioral incentive programs and that sort of stuff. And in the CARE model, there really isn’t even a place for that. That it’s really about looking at the whole kid and talking directly about what’s going on, not talking about points and levels and other things that are sort of more artificial. 

This wasn’t an agency repair job. Sometimes you bring models into fix something that’s broken.  We actually had a program that was running very well, but we wanted to take it to the next level. And I think that when we brought this in, it just became ... it caused us all to look at what we’ve been doing for the last ten or fifteen or twenty years and wonder if that was in the best interest of kids. And it did give permission to do some things that you weren’t really sure was okay historically. 

Like, all that work that you do in clinical training around boundaries and kind of defining roles and stuff between caretakers and kids gets somewhat called into question here. This kind of gives you permission to develop strong therapeutic alliances with kids and to kind of, like I said, co-regulate, to move forward with them in a partnership. As opposed to, "I’m the adult and you’re the kid and you’re going to do what I tell you to do."

It gave permission to excuse expectations sometimes. You get crazy around rule enforcement in group care. And that this was talking about kids that might not be able to meet the expectations, either in the moment or in general and teaching us to be able to amend those expectations to help the kids be successful, as opposed to kind of sanctioning them for not meeting their expectations. 

It also really puts the responsibility for the change much more on the adult than some of the previous thinking had been, is that basically the program model is designed in the fact that kids will do well if they can. And if they’re not doing well, something has derailed them. And it’s really incumbent on us to find out what that is and meet the underlying needs. So that the kids can get back on track for more spontaneous development. 

NCFY: For more information about the Care model and other evidence based practices, visit the National Clearinghouse on Families and Youth, online at NCFY.acf.hhs.gov.

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