School & Program Visits, 4/1997

Island View Residential Treatment Center opened for business in new buildings 30 miles north of Salt Lake City just two years ago. Two more new buildings have been added recently, completing the original plans for the program well ahead of schedule. Island View has a capacity of 96 adolescents and is already almost full at 87.

The main players at this program are Jared Balmer, Ph.D., a licensed clinical psychologist and Executive Director, and Kim DeLa Mare, LCSW, Clinical Director. A third partner, Lorin Broadbent, DSW is CFO and Director of the academic program. Jared and Kim worked together for 10 years at another adolescent RTC, operated by a national chain in Salt Lake, and both had years of other experience prior to that. Many of their staff moved with them to Island View.

Island View’s physical plant is well designed for its specific purpose and in a tasteful manner that makes it pleasant to spend time in. It has six 16-client units, half for boys and half for girls. Rooms accommodate 2 or 4 youngsters. A large gymnasium with hardwood floors and weight room, six new classrooms, an administration area and one 32-bed dorm unit are in the new buildings. The grounds are pleasant with many newly planted trees promising future summer shade. Most windows have views of Antelope Island to the west and the Wasatch Mountains to the east.

Island View is an intensive clinical program well designed for youngsters with significant emotional and behavioral problems. The average stay is six to eight months. About half of the children take medications, which are prescribed and dispensed on site. Virtually all clients are private pay or covered by insurance. Jared and Kim have been unusually effective in contracting with insurers, including managed care companies for coverage.

A number of features distinguish this program:

Each 16 child unit has two house parents who are in the unit 24 hours per day for three days in a row. They work 3 days on 3 days off, so their charges have only 4 house parents who are available around the clock, making for potentially closer and more family-like relationships than are available to children in a standard 8 hour shift system.

Each unit also has two Masters-level therapists available during standard work hours and some evenings. Each child gets at least one individual therapy session a week and a conference-phone family session every week. Family sessions are also held when parents visit. Both of the youngsters we interviewed for over an hour in Dr.Balmer’s comfortable office (without any supervision by Island View staff, a level of trust we appreciated), felt strongly that they were benefiting from their therapy work and it seemed to us that their self- understanding and emotional poise were excellent. The special feature of the therapist situation at Island View is that the lead therapist on each unit is responsible for all aspects of that unit’s functioning, and reports directly to Kim and Jared. We have seen this arrangement in one other RTC, and it worked very well there. It seems to be an important feature of this program’s success. It especially helps with communications to the “outside world,” since you only have to check with one person to get full information about a child you’ve placed at Island View. (Though everybody we talked to knew all 87 kids by name and how they were doing).

Units have group therapy (up to eight residents per group) for 1 ½ hours, five times a week. These are led by the dorm parents and a therapist, and deal with psychosocial issues and residents’ places in the status system. About half the children also attend one chemical dependency group and a 12- step meeting each week.

Activity is constant in this program. Apart from 45 minutes after wake up and again before lights out, there is only one 10 minute “break” each day and even weekends are very busy. This fits with our bias that busy kids tend to feel good about themselves and to stay out of trouble.

The children are more supervised than in other programs we have visited. This did not make it feel uncomfortable to us, nor apparently to the kids; but it is pretty clear that very little is going to happen here that is not observed by staff.

Boys and girls have off-set meal times and separate classes, do not share activities, and seem to have little contact at all. The boy and girl we interviewed had been at Island View for 6 and 4 months, but scarcely knew each other. We take this as not only an admirable effort to avoid trouble, but also a way of reducing the distractions that can occur in a coed program and, we would hope, of teaching these young people some things about self-restraint and the appropriately minor role of sexual interplay for young adolescents.

While the course-work appears to be fairly standard, go-at- your-own-pace RTC fare, we were very impressed by the progress reported by the young man we talked with, who was both ADD and dyslexic and had not learned to read until four years ago when he was 14. He clearly felt respected by, flexibly accommodated, and comfortable with the teaching process at Island View.

In fact, that probably nicely sums up our sense of this program: respect for youngsters, flexibility and accommodation to individual needs within a very well thought out structure, and feeling of comfortableness between students, staff and administration. Added to this are the excellent supervision, the unique therapist responsibility for each unit, the apparently high quality of clinical work, and the exceptional expertise and refreshing intensity of Jared and Kim.