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Opinion & Essays - Aug, 2000 Issue #72 

THE STRUCTURE SPECTRUM
A Tool for Matching Children with the Right Program
By: Lon Woodbury 

[The following is a revised version of an article that appeared in the August 1995 (#35) issue of Woodbury Reports newsletter]

One of the most terrifying and confusing experiences a parent can have is to realize their child is making extremely poor choices, and his/her behavior is becoming dangerous not only to themselves and others, but especially, to the child’s future. At this point all the hopes and dreams a parent has for their child disappear into a confusing whirl of drugs, and/or rebellion, and/or negative friends. When everything a parent tries does not help, it is time to look for professional help. 

Once the parents have decided to look for help outside the home, they experience an onslaught of emotions often accompanied by shame and doubts about their parenting, fears that they’ve failed their child, or a sense of hopelessness. At the same time, the parent must deal with a wide and confusing array of professional options, most claiming to have exactly the best program to meet their needs. What makes it so difficult is that this decision can impact the rest of the child’s life, also influencing the lives of others who are close to the child. A wrong decision could make the problem worse. At this point, more than ever, it is vital to approach this decision with persistence, cool rational thinking, and realism about the true nature of the problem. Outside advice needs also to be tempered by one’s own instincts, developed through years of experience with the child and the realization that the parent has a better understanding of what the child truly needs, than any professional ever could. 

The trick is to match the child’s needs with what the professional, school or program can provide. These programs are not all are the same, either in approach or competence, which is complicated by the fact that most programs and techniques look good, at least in their brochure, and most will say they think they can provide exactly what is most needed by the child. However, just as childrens’ needs vary widely, so does the structure and intervention offered by professionals, schools and programs. Making the right match is crucial for success. Overkill can be just as much of a disaster as under kill. Many failed placements are caused by parents choosing the first program they find that looks feasible, or by choosing a school by how close it is to home rather than how close it matches a child’s needs. 

One of the most helpful tools I have found for matching children with the appropriate school or program is to rank each program on a continuum according to the intensity of its structure. On this structure spectrum, a long term, secure, psychiatric based program would be at one extreme, the other extreme being living at home while participating in counseling or a day program. This is a subjective evaluation of course, based largely on a combination of my sixteen years experience with emotional growth schools and their students, coupled with on-going feedback provided by professionals who have placed children in various situations. 

The first step when working with this concept is to determine what kind of structure a child needs, based largely on his/her behaviors, diagnoses (if any), and response to other interventions. The next step requires deciding which schools and programs provide that level of structure. From those, pick several programs that seem to address some of the child’s other needs/interests as well. The following examples are just rough estimates, since many schools and programs have several levels of intensity. 

The way most parents commonly respond to their teen’s negative behavior is to try counseling and/or some kind of day program. This option represents the least intervention on the structure continuum. The child is still living at home, supplemented by counseling and perhaps a local day school that is equipped to deal with a child’s individual problems. This intervention is primarily for a child who still has some inclination to do the right thing, but is floundering and needs some occasional support. 

The next level of intervention would be a residential boarding school, which has the advantage of 24 hour a day supervision, often with supplementary counseling services available. For a child with negative behavior that primarily stems from the home environment or negative peers and just needs to get away, a traditional boarding school can be the solution. However, these schools can be a disaster if the child is not ready or willing to change their attitudes or behavior. It would just be transferring the problem to another setting. 

Even more structure is provided by residential boarding schools that are specifically designed to effectively deal with students with mild behavior problems, learning differences or drug involvement. These are often referred to as Transition Schools because they can be excellent for graduates of more intensive programs who are not quite ready to tackle traditional schooling. Transition schools have an academic orientation with a specific emotional growth or character education curriculum and the accompanying structure to provide immediate help for the floundering student. Examples would be Brush Ranch School in New Mexico, St. Paul’s Academy in Arizona, King George School in Vermont, the Hyde Schools in Maine and Connecticut, and Grand River Academy in Ohio. 

Continuing towards more structure on this spectrum would be “family-based” schools and programs. In these schools and programs, students interact with the local community, primarily through attending the local public school and taking part in organized community activities. These usually are in the “group home” or “foster home” model and the staff may or may not be licensed as therapists. They usually have smaller numbers of students and work with young people who need a safe, structured environment more than they need clinical care. Examples include Explorations in Montana and Shamrock Educational Alternatives in Washington. 

Next on this continuum are self-contained schools and programs that facilitate healing by means of an emotional growth curriculum, often with an overlay of counseling and therapy when needed. The terms “mentor” or “strong adult role model” or “teachers” would often better describe the daily activities of the staff than the term “counselors.” This category includes the CEDU Schools in Idaho and California, Cascade School in California*, Hidden Lake Academy in Georgia, Hampshire Country School in New Hampshire, John Dewey Academy in Massachusetts, Mission Mountain School in Montana, Mount Bachelor Academy in Oregon, and New Dominion School in Virginia and Maryland. 
[Cascade School closed January 20, 2004.]

Moving toward even more structure on this spectrum are the programs that provide psychiatric care as a routine part of their program, with an even greater emphasis on maintaining a tight structure. By not enrolling students who need heavy psychiatric care, they claim they can keep their costs down for the students who are appropriate for their program. Examples would be Forest Heights Lodge in Colorado, Valley View School in Massachusetts, Positive Impact in Mexico and the Three Springs Treatment Programs in Alabama, Tennessee, North Carolina and Georgia. 

At the top of the structure spectrum, are the programs that provide the most intense intervention. These programs are capable of treating serious psychiatric problems while providing an effective emotional growth experience. Their tight structure enables the child to learn and internalize how to make better decisions, such as how to stay away from illegal drugs, increase self-discipline, and become trustworthy. Examples include Provo Canyon School in Utah, Glenholme School in Connecticut, Island View in Utah, New Haven in Utah, Remuda Ranch in Arizona, and Villa Santa Maria in New Mexico. 

This list is not definitive, and the examples are tentative. However, the point is that there are a wide variety of approaches to working with teens making poor decisions, and until a parent has focused their search at the right level of intervention, the chances for a successful placement are reduced. In cases when a parent tells me of a “program failure,” further inquiry reveals that it was caused by improper placement. For example, when a child has a serious psychiatric problem that results in serious behavior problems, simple counseling will usually not work, nor will placement in a highly structured behavior program. A placement is also unlikely to be successful if a child is placed in a psychiatric facility when the main problem is attitude and behaviors. 

The first step is to develop a clear understanding of what the problem is, then determine the level of intervention that is appropriate for the problem. As is often said, half the solution of a problem comes from an accurate definition of the problem. A clear and realistic understanding of the causes of your child’s behavior problem provides information that is vital for choosing the right intervention. Neglecting this step is frequently the reason prior interventions have not produced the sought-after results. 

Copyright © 2000, Woodbury Reports, Inc. (This article may be reproduced without prior approval if the copyright notice and proper publication and author attribution accompanies the copy.)

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