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Opinion & Essays - Jan, 2002 Issue #89 

WHAT’S THE PROBLEM?
(According to the School)
By Lon Woodbury, C.E.P.

Every school that works with children with behavioral/emotional problems has a basic philosophy. Though perhaps not formalized into a written statement, this philosophy, or worldview, is the basis for the way in which a program attempts to answer the question: “Why?” Why do some children make self-destructive decisions, while others make constructive or positive decisions? The school’s basic philosophy then determines the kind of intervention they think will best change a child’s thinking and behaviors from negative to positive.

When a parent is comparing schools or programs, the usual custom is to look at externals, for example, the staff’s credentials, counseling techniques and amount of structure provided. Important as these are, a more basic way of comparing schools would be to examine their philosophy. This will reveal what the school considers to be the underlying cause of the child’s problem, along with the type of intervention the school is likely to emphasize. Only when a school’s philosophical assumptions match your child’s actual problems will the chances for success be maximized.

Schools and programs that work with struggling teens seems to adhere to one of three basic philosophies: Therapeutic, Emotional Growth, or Behavior Modification. Of course most schools and programs have some kind of a mixture of two or all three philosophies, so it might be difficult to tell which one dominates. However, if parents can determine which is the dominating philosophy of a school or program, then the parent can anticipate how specific situations would be handled.

THERAPEUTIC
This theory has dominated our society’s approach for working with negative behaviors since the early 1960s when alcoholism was legally determined to be a disease instead of a moral weakness. Based largely on studies in abnormal psychology, in its pure form it assumes negative behavior is caused by a disease or disorder, which must be cured, or at least treated. The assumption is that only after the “disorder” is controlled, will there be a chance for healthy behavior.

This theory is considered to be “science-based”, partly from its apparent precision as reflected in the DSM-IV, and is well accepted by the public for that reason. It is also is a great tool for relieving parental guilt: “No wonder my parenting didn’t work, he is ADHD.”

This is also the dominant expectation of legislative bodies and regulatory agencies: “How can a school or program possibly be safe or effective without a lot of credentialed therapists on staff?”

A program with this as its underlying philosophy has the goal of removing the disease, which in this case is considered the obstacle to healthy behavior.

EMOTIONAL GROWTH
This term, coined by pre-1990 CEDU schools, is based largely on principles of healthy living as found in personal growth books, studies and self-improvement seminars. It assumes self-destructive decisions are caused by delayed emotional development or immaturity, with the solution being to help the child grow up. Its key approach is to maintain a tight structure with immediate and appropriate consequences for negative behavior. Through consequences and a strong basic sense of right and wrong on the part of the staff, these schools attempt to duplicate as closely as possible, the typical growth and development of a child within a healthy family.

The goal of this approach is consistent with what philosophers such as Plato described as, “the virtuous life” and is comparable to “Character Education,” which has become popular in public school reforms in recent years.

Its goal is to change self-destructive and limiting attitudes.

BEHAVIORAL MODIFICATION
This was a leading concept in psychology in the 1950s, and is still a very influential concept. The explanation for why a child behaves the way he/she does would be, “Who knows?” Claiming that behavior is the only thing a person can really know about another person, the intervention through behavior modification is to require certain behaviors of the students. The assumption is that if the students start behaving in positive ways, the reinforced behavior is likely to stay with the child once the program is completed. The goal of a program with this philosophical orientation is for its students to achieve immediate conformity to staff expectations.

EXAMPLES OF EACH APPROACH
The techniques used by a program in a given situation will vary depending upon a program’s basic philosophy. The following are examples of how each of these three program philosophies will cause a situation to be handled differently.

A Behavioral Modification school or program will rely heavily on punishment, since in the short run that is the fastest way to achieve conformity. Often the punishment will be pointless physical work. An Emotional Growth school or program will reject punishment as counterproductive, especially in the long run, and develops its structure to emphasize consequences. This is so the child can learn the consequences of his/her behaviors, and thus grow in maturity. Consequences might be physical work, but always with a useful purpose so the child can have something to point to with pride that he/she had accomplished. How to discipline in a therapeutic school or program is not an integral part of their primary philosophy so discipline can vary widely among therapeutic institutions, depending on the attitudes of management and key staff. The philosophies can be a blend: the use of physical restraint is an extreme Behavioral Modification, which might be necessary in any institution. On the other hand, many successful therapists will integrate emotional growth attitude techniques to help create more positive attitudes as part of therapy.

The role played by staff differs in a fundamental way. Behavioral Modification staff plays an authoritarian role. The Drill Sergeant in a Boot Camp is a classic example of this role. “You do it my way or it will be painful.” Emotional Growth staff act as mentors, trying to duplicate the kind of advice that might ordinarily come from a kindly Aunt, Uncle or Grandparent. They are authority figures, but not authoritarian. “It is your decision, but this is what will happen if you decide to do this.” In a therapeutic school or program, staff, and especially therapists, are the ultimate authority figure, but whether they carry their role out as mentors or authoritarian figures depends on the personality of the therapists and the customs of the school or program.

The only decision allowed a student in a Behavioral Modification school or program is whether or not to conform to expectations. Even when a child is given increased responsibility and privileges, it is always dependent upon keeping the staff satisfied. Students in an Emotional Growth school or program can make many decisions, but must live with the consequences of their decisions. As their responsibility level increases, the choices they can make will expand. Again, therapeutic schools and programs can vary, from a popular image of beefy orderlies enforcing the rules, to another popular image of kindly therapists and staff sensitively helping children work through their issues.

In my seventeen years in this business, it is my observation that residential treatment for struggling teens has and is still drastically changing, reflecting changing philosophies in our society. In the early 1980s, students I interviewed that had been in therapeutic institutions usually reported they had either too much time on their hands with little to do between therapy sessions, or that in between therapy sessions they were subject to Behavioral Modification’s detailed expectations and punishment if they did not conform.

The quality therapeutic schools and programs I now encounter have dropped many of their Behavioral Modification techniques and have achieved a good balance using both therapy and motivational techniques to cause attitudinal change. I think this reflects a change in treatment concepts in this country. The success of Emotional Growth schools made the point that there were better and more effective ways to work with young people between therapy sessions - techniques and concepts that could better supplement therapy. Of course, it is still debatable whether it is the therapy or structure that has the most important impact on the patients/students. Though the popular vision is it is the therapy that produces the miracles, it is now obvious that therapy by itself is usually not enough. In other words, effective therapeutic institutions will need the two-fold approach of both working to remove pathological obstacles, AND creating a shift towards more healthy attitudes, if they want to be successful.

The above of course relates to residential intervention for young people suffering from serious mental disorders or diseases. How about the child that is just spoiled, angry or rebellious without a serious diagnosis? In that case, intensive treatment isn’t necessary, and the child can be better served in a school or program with Emotional Growth as a primary philosophy. If a child’s behaviors can’t be explained by obvious trends in psychological tests, an intensive therapeutic institution could be harmful; the child would be better served in a program that was primarily based on an Emotional Growth philosophy.

Behavioral Modification? It certainly seems to dominate juvenile justice systems, and I know few that are satisfied with the living environment or its effectiveness.

Hopefully this discussion has served to illustrate how a program’s philosophy can affect its overall approach, and why it is vital for parents to understand the causes of their child’s problem so they can make a more informed program choice - before they jump for the first plausible school or program they encounter.

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