THE EMOTIONAL GROWTH CHALLENGE-Section Three
-to orthodox mental health medical model treatment-
Section 3- (The Problem as I saw it continued)
Lon Woodbury MA. IECA. CEP
208-267-7717
Everything you hear is opinion, everything you see is perspective.
Attributed to Marcus Aurelius – 2nd Century AD Roman Emperor
[Section one described my first impression of a pioneer Therapeutic Boarding School, Rocky Mountain Academy (RMA) in north Idaho in 1984. Section two describes some examples of the existing problems some teens had from mainstream education and mental health treatment and the early attempts by RMA to provide better solutions for them. Section three here continues the discussion on the problems RMA was attempting to solve]
Another example I saw that comes to mind was another teen-age girl from southern California. She had been in a very expensive drug rehab program in a southern California Psychiatric hospital for adolescents and the parents felt it was ineffective and were looking for another approach. In my interview with her she told me the hospital experience was of very little help. What she told me was that the total tools of treatment were one-on one-therapy sessions, a weekly group session and her daily medication. She reported that other than that the patients pretty much had free time. In that free time, they had watched TV, socialized (which included boyfriend-girlfriend relationships), and on at least one occasion she had gone to the fence on the edge of the property to make a drug deal and brought the drugs back into the program. (I didn’t get confirmation on the drug deal from her parents, but they seemed to agree that the program was ineffective and weak structure was the rule). The lesson I learned from that was that in many cases, the program seemed to feel that formal therapy by a credentialed practitioner and medication were the only tools that could help troubled children. They also seemed to believe all else was just filler and unimportant for the mission of healing or treatment.
Another lesson I learned early on was that mental health diagnoses, as described by the Diagnostic and Statistical Manual of Mental Disorders (DSM), can be a very fluid and uncertain guide in real life. I learned this when I reviewed an application for a student and the psychiatrist report had a diagnosis of Schizoaffeactive Disorder. Although a rather vague and poorly understood diagnosis, it was a mental health condition that if accurate was beyond the capability of Rocky Mountain Academy to do right by that student. RMA did not provide treatment, but an environment for growth, and it was my instructions to recommend to the parents with a student having a serious diagnosis like that to find a competent treatment center or psychiatric hospital. I called the psychiatrist who did the report to explain my decision to reject her. He surprised me with his answer. He told me: “Don’t pay any attention to that, I just used that so the parents could collect insurance.” I learned from that to take every psychiatric report with a grain of salt and always do further checking and always have a conversation with the referring source, which is what I had inadvertently done in calling the psychiatrist.
Another lesson I learned was that sometimes, the parents have the problem more than the child. Maybe a better way of saying that is that in those cases the parents were the child’s problem. I first was confronted by this problem early in my job. The first time I was confronted by this possibility was when a family appeared for their appointment one morning at the school for the intake interview (which usually took hours, and sometimes all day). It took a long time for enrollment because the goal was to make sure the student and parents knew what to expect, and for the student to agree to stay. Our procedure was to do a tentative enrollment in advance based on the phone discussions and through reviewing the paperwork. Actual enrollment was based on the interview. After meeting the family, I followed our usual procedure by turning the daughter over to a couple of senior students to give her a tour of the school (without any staff present) and for them to explain to her their thoughts on the school. I then took the parents to my office to talk about the issues the family had been having with her. The mother recently had remarried, and it was the step-father that had come along with the mother for the enrollment. The problems came down to: the daughter and step-father had not been getting along; the daughter had been rebelling and sassing the parents; and they told me her grades had been slipping, which was an area of major concern. They answered in the negative of any concerns about problems with her sneaking out at night or staying out late, signs of drugs or promiscuity or associating with wild friends, or any of the common problems our students had been having when they had enrolled. Except for the seriousness of the parents’ emphasis, it sounded to me like normal teen behavior and certainly not requiring a residential intervention.
I noticed it was the step-father who was most insistent the enrollment was necessary, and the mother seemed to be passively going along based on his insistence the enrollment was necessary for the good of the daughter. The clincher in my mind was when I asked how far the grades had slipped. The step-father answered she had been getting 4.0 grades, but that year had slipped down to a 3.6 grade average. I was not convinced she needed anything as intensive as RMA, but maybe did need an intervention of some kind to solve the problems with the step-father. A traditional boarding school might have been better for her. After explaining she did not fit our student profile and being in a school with students with more serious and self-destructive problems might make things worse for her, I sent the three of them home. Parents all too often misrepresent the home situation and the child’s behaviors, or their reasons for the enrollment. That was when I learned that looking closely at the home situation and comparing it to the therapist’s verbal perspective was necessary to determine the true need and exactly where the problem was. I found especially important was obtaining the therapist’s verbal informal perspective on the parents since these are the kind of thoughts professionals are reluctant to write down but closer to the truth as the therapist sees it.
Comments and discussion welcomed
To be Continued in Section 4 (Problems summary)