Dr. Donald MacGillavry, Director Jongeren Advies Centrum
Amsterdam's Trojan Horse
A Report on Holland's Pink Pamphlet Movement
The people who work for Jongeren Advies Centrum (Young People's
in Amsterdam, don't restrict their activities to helping
people adjust to the status quo. If the problems their clients are struggling with arise from inadequacies in the social structure,
they take action on those, too.
Since the centre is financed by government and municipal
subsidies, the Dutch government and the City Council of Amsterdam now find themselves in the unusual position of paying people
to uncover and expose faults in the way they do their job.
This sounds like one of the more useful ways governments
can spend the money they take off us in taxes. We hope the Dutch authorities concerned will have the maturity to stay with
it and we hope this practice will spread to social agencies and governments in other countries. (A Canadian experiment with
some similarities, the Company of Young Canadians, failed to weather government and public criticism and their activities
have been somewhat curtailed).
JAC is located in a pleasant old house in the
centre of Amsterdam. It provides a nonauthoritarian, "no waiting" kind of help which the clients themselves will be asked to evaluate
at the end of the first year's operation. In the following interview, psychiatrist Dr. Donald MacGillavry, JAC's director,
discusses the philosophy and operation of the centre with Philip Veerman.
Mr. Veerman: How does JAC differ from some of the more conventional social service or welfare centres?
Dr. MacGillavry: We have organized the centre to suit the needs of the young people who
need help, rather than the convenience of the staff. For example, we are open from until ; after school and working hours. We can be reached by telephone during the daytime and we
will open the centre during the day in an emergency, but the staff are concentrated during the evening hours, the most convenient
time for the young people we are trying to help. The centre was opened on January 10, 1970, as a place where young people between the ages of 15
and 25 might come, on their own initiative, for information, advice and help.
Mr. Veerman: Is help not available to these young people through other social welfare
Dr. MacGillavry: Yes, but not in a form which is acceptable to most young people who are
put off by a clinical or bureaucratic atmosphere. Many government offices have conventional office hours. Some agencies only
see people who have been referred by a doctor or social worker. The staff of many agencies are prejudiced against young people—especially
young people with long hair or unconventional clothes—and are rude and unpleasant in their dealings with them. Almost
all agencies have a waiting period. Then when, at last, you get an appointment, you have to sit around a waiting room for
hours before you get in to talk to someone. Young people flock to JAC because they don't have to make an appointment, they
can walk in off the street. They don't have to fill in forms, or take a series of psychological or other tests before they
can see someone. They get to talk to someone right away about what's bothering them. The service is confidential. We don't
get in touch with parents, school authorities, employers, or anyone else, unless they give us permission. If they don't wish
to, the young person seeking help need not give us his name.
Linked to social action
Another way in which we differ from the conventional social
agency is that we don't restrict our activities to counselling individuals, helping them overcome their personal problems,
or helping them adjust to the status quo.
We look at the individual and we look at the society in
which he lives. We always ask ourselves: "What percentage of this problem is due to a failure in the functioning of this person,
and what percentage is due to a failure in the functioning of society?" It is always a combination of the two. But too often,
in the past, social agencies have concentrated on the frustration tolerance of the individual without considering whether
he might have a valid reason for his frustration. For example, a large percentage of the problems which people bring to JAC
are a direct or indirect consequence of the severe housing shortage in Holland, particularly in Amsterdam. A social worker who failed to take into consideration the shortage
of living accommodation might diagnose a person seeking help as having "a neurotic personality". But we need to face the reality
that young people, especially young married people with children, cannot live successfully with older people in crowded quarters.
One of JAC's basic objectives is to highlight problems which young people face today, and try to create activities which may
help in finding appropriate solutions to those problems. When we have hundreds of people coming to the centre for help with
problems that stem directly or indirectly from a lack of suitable living accommodation and we discover that out of 600 people
who went to the office of Amsterdam's housing department, only 10 were helped, then obviously some action is called for. Our first approach is to the
government or city department concerned. But if we fail to get satisfaction from them we notify the press. You can imagine
the stir that was caused when, in an interview with MET PAROOL (Amsterdam's biggest newspaper) I stated that in trying
to find solutions for the people who seek our help we receive co-operation from all the official agencies with exception of
the housing department of the City of Amsterdam. This is the way we work to get action. Most social agencies gather
these kinds of statistics but the usual practice is to pass
the information on to government departments concerned, supposedly to help them formulate future policy. What usually happens
is the information is filed away and ignored. The information we gather we hand over to the newspapers in the hope that the
publicity will prod the government into action. The government knows where the newspapers get the information. It helps keep
them on their toes but it also creates a tricky situation for us. We are a strictly independent, professional foundation
but we receive subsidies from the Municipality of Amsterdam and the Ministry of Culture, Recreation and Social Work. What has happened
is that the authorities are supporting an organization which gathers critical information which sometimes forces them to change
their policies or their methods of doing things. The Minister of Culture, Recreation and Social Work (the only woman in
Holland's present cabinet, incidentally,) supports JAC and understands the longterm value of the work we are doing, but
there has been criticism and annoyance in official
circles and there is a strong possibility that our subsidies
might be discontinued. But I do not see the point of trying to patch up problems while ignoring the root causes. To get rid
of the root causes you have to bring about change. There are two ways of changing things. One way is to talk to the people
responsible for the way things are and try to reach an agreement with them about the changes that need to be made. We have
achieved quite a lot that way. For example, we talked to the people at the Burgerweeshuis* about the need for a crisis centre
and they are co-operating with us to set one up and we will get a subsidy for this. This has all been achieved by discussion
and coming to a consensus. However, this way doesn't always work. It hasn't worked, for example, with the housing department
of the city of Amsterdam. Then you have to turn to the conflict model.
This may mean strikes, demonstrations, sit-ins. When we found we could get no action from the housing department we turned
to the newspapers, the radio and television stations, to see if publicity could force them to act. If this doesn't bring results
we might have to put an advertisement in the Amsterdam newspapers asking all those who have housing problems to join us in
a sit-in at the housing department offices. People may say we are crazy, but when 30 per cent of people who come to JAC have
problems which stem from the impossibility of finding somewhere to live, something has to be done. And if you can't get something
done through discussion you have to find another method.
Time ripe for change
I'm not alone in this belief, of course. The time is ripe
for change. Many workers in the mental health field realize that they have been working for the economic structure of the
consumer society rather than for the people they are supposed to be helping. Too often, in the past, we have worked in the
service of "establishment" parents instead of in the service of the child. Up to a few years ago I, as a psychologist, saw
nothing wrong with parents asking me to test their children to see how many extra lessons they could take through high school.
I tested children; I chose, at the request of the parents, to force them into a productivity type of achievement. The end
result was that they passed their final high school examinations with high marks but somewhere along the way they lost all
their natural creativity. Of course, at that time, any psychologist who counselled parents not to ask so much of their children,
would find it difficult to earn a living because once his reputation spread, few parents would consult him. But now one can
find more and more workers in the mental health field who have no wish to put their talents at the service of people who think
that the good society is based on productivity achievement and the accelerating consumption of material goods.
Mr. Veerman: What kind of people staff the centre?
Dr. MacGillavry: Before we opened the centre we sat down and asked ourselves what kind
of staff we should look for. Should we take only psychiatrists and psychologists? Or should we use social workers, too? We
decided that social workers who have specialized in adult education and group work, cultural workers as we call them in Holland,
would have the right kind of attitude for this type of work. These people have lots of experience in dealing with people and
dealing with conflicts. They tend to be critical toward the established structure of society. They also have a very good way
of talking to the young people who come seeking help. Why? I don't know. They cannot explain why themselves. But it has been
our experience that these cultural workers develop a much
better rapport with our young clients than the highly trained
psychologists or social workers with advanced training in casework.
Mr. Veerman: When I looked around the centre at two o'clock this morning I saw people
sitting in corners, talking. A girl brought coffee around and pop music was playing in the background. I saw no special rooms
for interviews, no clinical atmosphere. It reminded me of the Browndale treatment centre and of the Browndale film "Carol
and Dr. Fischer: a model for a psychiatric interview" which shows a psychiatrist talking to a child in the same informal and
Dr. MacGillavry: Yes, we have the same relaxed atmosphere here. Most people sit downstairs
to talk to us. They prefer this to special interview rooms. But we do have a few rooms upstairs for people who request a private
interview. Couples often prefer a private interview room, and so do people who are very depressed and have attempted suicide.
Sometimes a person says: 'I can't talk here, there are too many people around' and then we take them upstairs.
Mr. Veerman: You say that these cultural workers who do not have a special training
in interview techniques do better at JAC than the highly trained psychiatrists,psychologists or caseworkers. Would this be
because they have a different attitude toward the person seeking help? Would you agree with John Brown that you don't have
to be an expert with years and years of training before you can work with people?
Dr. MacGillavry: Yes, I would agree. One important thing which helps our cultural workers
is that most of them are around 25 years old—not much older than the clients. I think, also, that the kind of training
that most psychotherapists get prevents them from being able to give the kind of help which is needed at JAC. The focus of
their training is on long-term therapy. But our focus is on crisis help. In our kind of work you have to get through to the
person and get the information you need quickly—perhaps in one interview, if the person seeking help doesn't live in
Amsterdam. So you have to be able to talk easily but you also need skill to direct the interview the way it
needs to go. This can be a difficult combination to achieve
and my experience has been that cultural workers find it easier than other professionals. However, we are a good team here.
From the cultural workers the psychiatrists learn flexibility and from the psychiatrists the cultural workers learn therapeutic
principles, the importance played by transference and counter transference and other technical skills.
Another important thing that our experience at JAC has taught
us is that a hierarchical organizationalstructure results in an authoritarian way of helping people. A non-hierarchical organization,which
we are, produces a non-authoritarian form of help which the young people can accept. JAC is more or less a "working commune".
When I open my mouth to say something I sometimes get less response than the cleaning woman when she says something. This
was especially true when we first opened. The attitude then tended to be: "When Dr. MacGillavry opens his mouth don't listen
because he is still thinking that he is the director. When he no longer thinks of himself as the director we will listen to
him." But I say I am not the director except for outside purposes; I am a member of the team.
Mr. Veerman: How does this team approach work?
Dr. MacGillavry: We work in units of four people and the units change every three months.
So for three months you are working with the same people for two nights a week.
A young person walks in and I may sit down and talk with
him. Now the problem that is presented might be one that I can deal with adequately without consultation with anyone else.
Or it might be one that I think the cultural worker is better equipped to handle. If that is the case I will say to the young
person: "Do you mind if I call in my colleague? He has more experience with this kind of thing than I have." Then there are
three possibilities. The cultural worker might sit in on the interview for 10 minutes or so to give us the benefit of his
knowledge on some specific aspect of the problem. He might stay for the whole interview. Or after 10 minutes or so I might
withdraw, leaving him to take over. This leads to a very flexible approach. Everyone contributes his own particular skills
to the team. This leads to the client getting the best advice and help available for his particular problem.
For this approach to work successfully,everyone on the team
must know what he can do and what he can't do. It isn't easy for a highly trained professional person to admit there are some
things he can't do or that someone
else can do better. Before we opened we did a lot of role
playing to help us find out what things we were good at and what things we didn't do so well. When a professional person can
admit he isn't infallible, he can take a non-authoritarian approach to the client. You can discuss alternatives with him and
suggest what might be the better thing for him to do, instead of telling him what he must or should do. An important aspect
of our work is the follow through. The staff person who has the initial interview with the client (or the person who takes
over at the first interview) keeps the responsibility for the client until he gets the help he needs. For example, some people
we see need long term psychiatric help, but all the treatment centres have long waiting lists. It sometimes takes months before
a person gets in. But the JAC person maintains contact with him and responsibility for him and during the waiting period the
young person can come back to see the JAC staff person as often as he needs to.
Mr. Veerman: Do you have any on-the-job training for the staff?
Dr. MacGillavry: We have the usual staff meetings to discuss organizational problems and
special meetings at which we discuss the more difficult cases. Then every other week we have a two-hour meeting during which
we talk together on a more personal level, about our feelings. A highly trained group worker, Mr. Hirsch, does this with us.
For every person who comes in we write down the problem he presented to us and our suggested solution. All the questions and
answers are gathered up at the end of the shift and handed over to the staff who come on duty the next evening. They discuss
and evaluate the help we gave. We have 20 part time staff persons at JAC so everyone gets 19 critics. In addition to working
two nights from 7 p.m. until 3 a.m., each staff member has one day of meetings, in-service training, and at least one day
for social action work.
Mr. Veerman: What form does the social action take?
Dr. MacGillavry: Well, first of all, they have to design a social action concept to suit
a specific problem. I'll give you an example. On Liberation Day (editor's note: May 5, national celebration of the anniversary
of Holland's liberation from Germany during the Second World War) there were riots in Dam Square (main square of Amsterdam)
resulting in mass arrests.
Treated badly by police
Among those arrested were 140 young people who had been
sitting by the national monument. Many of them were treated badly by the police. Those who were injured had to wait four hours
before seeing a doctor. Some who were on medication were not allowed access to it while they were in jail. This was an incident
which called for social action. So we got busy. We talked to the young people in this group to find out how many of them would
like to join JAC personnel in forming a social action group whose purpose would be: first, to try to find out why the police
had acted that way; then, to see if we could make contact with the police and discuss the incident with them; but, perhaps,
if we didn't get any satisfaction, to bring a court action against the police. The social action that we undertake is always
linked to problems which young people bring to our attention. We believe that an important part of our job is to expose the
problems in our society; to highlight the areas in which help is needed but no help is available. Since we opened last January
we have been able to highlight, and do something about, several of these shortages. For example, many young people run into
problems with the law and they cannot afford a lawyer even if they could find a sympathetic one. So we started a judicial
counselling hour at JAC. There is a shortage of information available on hard drugs, so we started a regular two-hour consultation
program on hard drugs. Young people with long hair have difficulty in finding jobs. Also many young people don't want to work
at a conventional job from 8 a.m. Monday morning until 6 p.m. Friday afternoon. We think it is quite reasonable for a young
person to not want to become a slave to the exploitive, consumer society. And we have started an experimental job finding
agency to see if we can help them find the kind of jobs they will enjoy doing. Very little help is available to pregnant single
girls so we started an abortion clinic. We also organized group meetings for girls who have had an abortion so that they could
talk about their feelings with other girls who had gone through the same experience. It is important for a girl to know she
isn't the only one who has faced this problem.
We want to work more with group techniques at JAC. We are
thinking of setting up therapy groups for young people who are struggling with the same kinds of problems. Some of them need
individual help but many of them could be helped in a group. Mr. Veerman: What are the most frequent problems you deal with?
Dr. MacGillavry: A very large percentage are a direct result of the severe housing shortage
here. Some young people come because they can't get jobs, some have drug problems, some have problems in relationships with
other people. We also get quite a few young people who have run away from home, or from an institution.
They get into a big conflict with their parents or with
the staff of the institution and they run away. But they have nowhere to run to. They sleep in the parks, or in the streets,
the girls sometimes prostitute themselves to get a bed for the night. Young people reach a period in their lives where conflicts
with parents or other authority figures are inevitable. Sometimes they need a temporary refuge in which they can stay while
they try to work through their problems. The solution might well be to return home, or to the institution. But if they are
forced to return prematurely, before they have sorted things out in their own
minds, nothing is resolved. So we are working with Mr. Wim van Halm, the director of the Burgerweeshuis to set up a crisis
centre where these young people could stay for up to a week. They wouldn't have to worry about finding money to pay if they
didn't have any. The only condition would be that while they were at the centre they would have to try seriously to work through
the problem which brought them there and decide what they should do. Such a centre might also be a useful referral for young
people who come to JAC and who turn out to be in need of intensive individual therapy.
Mr. Veerman: How do the young people get to know about the service JAC offers?
Dr. MacGillavry: Through other young people whom we have helped. They form a bridge. They
are the ones who are in contact with other young people who need help and they can say: "Why don't you go to JAC? They helped
me and they could probably help you. I'll take you there if you like." The fact that the referrals come from the people we
have helped provides a built-in evaluation service. Because if they hadn't found our help valuable they wouldn't recommend
us to anyone else. At the end of our first year of operation we'll do an evaluation on a more formal basis. We will meet with
a group of young people whom we've helped and ask them: Are we doing a good job? Is the program valuable enough to be worth
continuing? What do you think needs to be added to the program to make it more valuable to young people? From January until
the end of May (time of the interview) 2,700 young people have come to JAC for help. Of these, 70 per cent were living in
Amsterdam at the time, 15 per cent were from other parts of Holland and 15 per cent from other countries. One criticism that
is levelled at us sometimes is that the work we do at JAC is too superficial, that we focus too much on surface problems,
on crisis intervention and neglect long-term treatment needs. I don't think this is true. If a person needs long-term, intensive
therapy we refer them to a treatment facility which can offer them this. By getting immediate appropriate help to the others,
we perhaps prevent their problems from building up. Because JAC offers help in a form that is acceptable to young people,
they come to us before their problems become too serious and this enables us to do a lot of preventive work.
Mr. Veerman: Are there any changes you would like to see made in the child treatment
Dr. MacGillavry: In many cases we are not convinced that there is a good reason for this
particular boy or that particular girl remaining in a child care institution. We think that in an attempt to keep down the
rate, the standard of functioning a child must reach to get out of the institution is too high. It would be better I think, to take a chance on whether a child might make it
in order to give
him an opportunity to enjoy the normal experiences that every adolescent has a right to. At this time of life particularly it is important that a child live as normal a life
as possible. And if he gets into difficulties I don't think this should mean he has to go back into the institution. We can give him the support andhelp he needs while
he is living in
the community. I don't think we explore these possibilities sufficiently. To prove to yourself and others that you can master something is a normal need at this age, an essential one. Most child care institutions are too rigid in their structure and environment. They don't give a child the chance to
show what he could achieve. I admire the things that Mr. van Halm is doing,
changing the Burgerweeshuis from a classical treatment centre to a dynamic treatment
centre, opening family style houses in the city of Amsterdam, using foster
families, helping the child see the possibilities
that are available and helping him make use of his potential and achieve self identity. At JAC, we think achievement of an
identity and self-determination are especially important for this age group between 15 and 25. Mr. van Halm agrees
with us on this.