PARENT ORIENTATION

While your adolescent is in our program, we feel that your cooperation and understanding is most crucial to our overall effectiveness.

We offer exceptional care for young people. The program day is long and intense; and in order to achieve personal growth and scholastic success, a teenage resident must consistently perform in ways they never had before!

We also adhere to a emphasis of family system participation as a process of education and support to the primary care of the adolescent. It is therefore necessary to provide a systematic format for the development of the family system as an effective and efficient problem-solving unit. In order to initiate this process and help the entire family system move from a “stuck” position, we provide this list of guidelines for your review. These guidelines are especially important as they address potential “TRAPS” for all members of the family system:

1. No contact with your adolescent for the first 72 hours of care. This moratorium allows for an opportunity for the adolescent to “thaw out”, reduce the “crisis interval”, and facilitate an attachment to the program milieu. This time allows parents and other family members an opportunity to identify their own distress issues and to separate adult from adolescent needs.

If you want to check on the status of your young person, you may call, not visit, the Primary Therapist or Executive Director for an update. Your adolescent will not be permitted to call anyone during this moratorium period.

2. Visiting policy is restricted to family members, and is initially limited to scheduled family therapy sessions or appointments approved by the Primary Therapist. Other visitors must be pre-approved by the parents and the Primary Therapist.

Note: Please remember that “I thought that since we were in the neighborhood we would drop by” will not be approved! This type of communication may be quite harmful, may constitute a confusing or double message, and is disruptive to the milieu and schedule. As the treatment process develops, visits are more liberalized.

Given the intensive level of service offered by the Institute, attempts have been made to evaluate admission criteria and to utilize the data in determining the most appropriate families for our treatment. Several characteristics have been observed. We have identified that a gateway relationship exist between: (a) the severity of emotional and medical disturbance (Axis I-II-III); (b) the adaptive level of functioning (Axis IV-V) of the adolescent; (c) the adolescent's role in the family, and d) the ability of the parent(s) to be responsive and actively participate in treatment at our recommended level of care. These criteria are reflective of the level of prescribed care and are based on more than the severity of the presenting symptoms of a child's mental or emotional difficulties. Treatment is clearly related to the personal, familial, and social supports available to the adolescent over the course of his/her psychiatric illness, developmental progress and/or adjustment difficulties.

Specifically, several parental patterns are recognized as relevant to the successful implementation of the recommended course of treatment. The ability of the parent(s) to follow through with treatment plans is crucial in determining the level of care in conjunction with the specific needs of the adolescent. Parental feelings and associated decisions stemming from embarrassment, denial, exaggeration, shame, guilt, or anger directed toward the adolescent may indicate a broader problem. These and other family dynamics are considered in determining the recommended level of care and address an intervention beyond a temporary "quick fix" solution. We differentiate the "problem" from the complaint and direct treatment at the problem, not the complaint! The "system maintained or system maintaining behavior role" of the adolescent in the family system yields significant insight and opportunities for appropriate interventions designed by our staff.

CARE FOR PARENTS - WHY IS IT NECESSARY?

We have experienced and documented the clear necessity to include the family members of an adolescent in treatment. Our focus with the parents(s) is specifically aimed at the preservation, re-negotiation, and further development of their marital relationship.

Typically, parents are guided by a rational desire for ongoing family stability. They try to adjust to the behavior of their adolescent in order to maintain some sense of balance and family equilibrium. Essentially, as the adolescent becomes more disruptive, the parents usually put more energy into trying to keep the family balanced. As a result, much of the parent’s energy, usually quite emotionally charged, begins to take its toll on the marital relationship. In some instances, the parents view the behavior of their adolescent as a reflection and public symptom of their relationship. Parents may in turn blame each other, defend their own respective views, and eventually avoid each other in subtle ways!

The marital relationship is unique and is separate from the role as parent. Most parents are very aware of their parental relationship, but then tend to overlook the marital relationship as the behavior of their adolescent absorbs more and more of their attention and energy. The adolescent may serve the function as being the most powerful family member while the parental coalition becomes less effective. The parents, as "family executives," may be in their own crises and in need of immediate and specific attention!

Family treatment, as previously discussed, has a threefold emphasis and focus:

(1) helping family members recognize that some adolescent disorders are family illnesses through a process of education, communication and problem solving exercises; (2) assisting the family unit in developing as the primary support and recovery system for the adolescent; and, (3) supporting the parent(s) in the role of "family executive(s)". For out-of-state adolescents, a modified intensive family treatment program for parents will be developed.

In addition, some parent(s) who live a significant distance from the Institute may be required to be physically available on campus from 24 to 72 hours during the intensive 24 hour phase of treatment for their adolescent,one to three times during the course of care.

All parents receive specific educational reading materials, attend the Adolescent Peer Evaluation Group, weekly Parent Survival and Education Group, and Expressive Therapy Group as part of the Parents' Day [Thursday] program. All parents complete a written evaluation report reflecting their experiences in this intensive Parents' Day component. Parents' Day is individually determined and scheduled well in advance so that parents can make appropriate work-related or child care accommodations. Mothers and fathers are scheduled so that both parents are not on campus on the same Parents' Day. An exception may be made for out of state parents.

The PARENT SURVIVAL AND EDUCATION GROUP

Research has shown that parents who are willing to learn, open to change and take responsibility and accountability for their own behavior tend to do better in their therapy and tend to be more effective in their parenting practices.

The Institute’s Parent Survival and Education Group has been evaluated by parents for many years as extremely important, informative and instrumental in their efforts to establish an accurate perspective while engaged in marital and family therapy sessions with their Primary Therapist.

The Parent Survival and Education Group is a parent’s management process and an important educational experience. Parents and guests meet for a weekly education session during the 24-hour phase of treatment. This is an open multiple family and guest group meeting where parents are afforded the opportunity to meet other family members at various stages in the treatment process. Each meeting has a general "theme" which may include a tape/film, handout, or presentation by Institute staff members. As an educational experience, the Parent Survival and Education Group will allow each parent the opportunity to return to the role of "family executive(s)" and the adolescent's role as the "most powerful" family member is reorganized in a healthier, more constructive manner. Parental self-disclosure is optional. Parents are taught how to explore and enhance relationship dynamics, curiosity, how to challenge, confront, consequence and confirm with their adolescent. The Institute's intensive milieu and partial care programs seek to enhance parental self-responsibility for adolescent development; increase parental self-confidence; accelerate the process of self-regulation within the family members; and introduce more effective problem solving techniques and methods for family members.

This educational experience requires an open mind and commitment to change. Each parent is required to complete a written feedback questionnaire [3 questions] at the end of each presentation which will be reviewed and utilized by the Primary Therapist to assist you in achieving new concepts and principles of parents, appropriate treatment goals and objectives for your adolescent.

Remember, flaws in problem identification and in problem solving techniques often include denial and the blaming of others, as well as a failure to interrupt beliefs and practices that are ineffective and inefficient. These parental patterns are discussed as are specific adolescent behavior patterns during the Parents’ Survival and Educational Group . This group is mandatory for parents!