General Interest > The Melting Pot

Interesting Cafety Article

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DannyB II:
(redacted, your focus will be on the topic as well. )

Back to the subject, I read all the 7 pages that were presented, quite a bit of info to digest at one time. Personally I do not believe that the majority of the existing programs would adapt any of the changes set forth here in these pages. There would be a residual atmosphere of philosophies still dictating standards of behavior methods.  We would have to shut them down and start over in order to get any effectual treatment plan going.  
There is a new crop of programs, some have been in existence and others are coming. They are smaller and want to stay that way, there staff are highly schooled and trained. Example; Wisdom Ranch School / http://www.wisdomranch.org/Program.htm.
I am looking forward to this new age of treatment plans, where kids are not necessarily sent away all by them selves for long term, families are demanded to be involved and if not they do not accept your child. They have competent Psychiatrists available for your child with the parent actively involved, staff are educated and trained to deal with children with disorders. Where restraints are not as common for two reasons, one staff are trained to not let incidents escalate and two kids with histories of excess violence are not accepted.
I am not sure what to do with the excessive cases, children with severe anti-social problems, psychotic pathos. I was not one and though I was thrown in with a bunch during my juvenile years, I would not wish this on any kid who does not suffer from these abnormalities.
Just some thoughts I had early on.

blombrowski:

--- Quote from: "Whooter" ---The most critical here, for me, in my experience was the Transition Phase. Trying to provide a seamless transition form the safety of the program back into the real world is a difficult task, as I had witnessed. I think more than the other phases this one would benefit the most from the childs input.
--- End quote ---

Which is why if residential treatment is to be used, it should actually resemble the real world as much as possible, because absent that you have the failed transitions that so often happen.  In a well-functioning program, youth and family contact should be frequent (every day or nearly every day from the very start of the residential treatment episode).  The concept of having a community-based program is that the youth can regularly practice what they learn in treatment with their family and their community.  Say Johnny has a temper and get's easily frustrated when he doesn't get his way.  Johnny gets to play on his local basketball team, and if he gets thrown out of the game for punching another player, he gets to go back to the residence and process why he did that, and hopefully the next time he's on the court, he doesn't do that again.  Or let's say Johnny likes to hit his sister when she asks for her Ipod back, Johnny gets to learn how to share with others while he's in the residence and practice those skills when he's at home.

But let's be honest, that would require parents and family to put up with some rather unpleasant behavior from Johnny.  If residential program A is saying we'll take care of everything and in a year your Johnny will be as good as new, we'll just have to figure out how we're going to transition him from our bubble where if he punches people he get thrown down to the ground and restrained, to your home where if he punches people you either do nothing or call us and send him back to the program, and residential B is saying for the next year you'll have to deal with Johnny every weekend, and you'll have to do the hard work of learning what Johnny's triggers are, and putting in the effort, and in the end Johnny is still going to be a rude teenager, but he won't get violent, the typical "program" parent is going to go with A, while maybe the more concerned, more thoughtful, more patient parent might go with B.

And even if program A isn't making girls wear french maid outfits, or putting youth through LGATS, or putting youth in isolation for days at a time, or restraining kids so hard that they break kids' bones, or even if they don't participate in the escort service business, Program A is still problematic because on average it doesn't work past the date that the youth comes home from the program, and if it doesn't work past the date that the youth comes home from the program, what good is it?

Program A describes traditional residential treatment, and most residential treatment programs fit the description.  Bills like H.R. 911 are great for dealing with the programs where easily identifiable and verifiable abuses occur.  But to deal with Program A you need to change hearts and minds.  Hard when the people do it because that's just the way things have always been done.  Nearly impossible when their livelihood depends on doing it the way that they've always been done.    

Last year I was at the AACRC conference and the IECA conference about a month apart.  The folks at AACRC at least give lip service to this kind of transformation, CEOs who want to transform their programs, but who have to basically fire their entire staffs (or spend years retraining those staff) who are comfortable with doing traditional residential care to get anything done.  The folks at IECA were unrepentant about the traditional residential treatment model.

I'll say this again, this isn't about abuse, it's about outcomes.  And the long-term outcomes for traditional residential care are terrible.  This framework for engaging youth and families and communities from the very start of a residential treatment episode has promise (which has the salutary effect of creating an open, transparent program that makes abuse and coercion less likely), but only if people are willing to do it.

blombrowski:
http://www.aacrc-dc.org/public_policy

For those of you who are interested in reading the seven policy papers.

Che Gookin:

--- Quote from: "Whooter" ---Young people who have been placed in residential settings recognize that residential providers typically operate with the best interests of the young people they work with at heart. .........even in the most extreme situations when the measures being used upon the young people in their care are abusive. While such cases may not typify the field of residential treatment, they do highlight legitimate and serious practice concerns.

The above statement indicates that children who have gone to programs realize that programs and staff have the best interest of the children at heart and that although abuse does occur within the industry it is not typical of program practices.  

This runs counter to what many posters here on fornits believe and further shows that the feelings towards programs here on fornits is grossly outdated and they are out of touch with the current kids entering these places.  I think as we bring in more of the current information about programs and let some of the old thoughts and practices of programs like Straight go fornits will be brought more inline with current practices and thinking.



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--- End quote ---

Simply because the statement is made doesn't mean it is a logical or correct one. Many survivors of programs both current and past have had experiences with said programs that lead them to believe the only interests at heart are those of the program's profit margin. You are cherry picking survivor experiences to fit your argument.

The ideas in the article are of merit, however, many of the claims made by this article like the one above ought to be removed.

Not all residential programs are making changes towards Youth based care and very few of them have the best interests of the youth at heart. Again though, the specific ideas of Youth based care are interesting to me, but the exaggerated claims on behalf of all survivors are a bit off putting.

Whooter:

--- Quote from: "blombrowski" ---The concept of having a community-based program is that the youth can regularly practice what they learn in treatment with their family and their community.

I'll say this again, this isn't about abuse, it's about outcomes. And the long-term outcomes for traditional residential care are terrible. This framework for engaging youth and families and communities from the very start of a residential treatment episode has promise (which has the salutary effect of creating an open, transparent program that makes abuse and coercion less likely), but only if people are willing to do it.
--- End quote ---

I agree that community based programs would be the best option for exactly the reasons you pointed out and this would eliminate the need for any drastic transition program back into the community.  But there will always be those few kids who do not respond well to these programs and need to be exposed to a highly structured environment over the period of several months to a year to modify the childs behavior.  Once this is accomplished there will still be a need to figure out how to transition the child back into society.  So it is important to continue to pursue this research in my opinion.

I think we can all see that the programs are getting better in general, as the article pointed out.  But it is a slow process and many of us have a hard time waiting for the change to occur.  I think what gives us all hope is reading the stories here on fornits, like straight, where the kids were forced to eat rotted food, held in isolation rooms and abused like cattle, no professional counseling vs the programs of today which cater to families with a Vegan, vegetarian or other life style, have no corporal punishment or fences, provide on-site/off-site education and licensed therapists, conduits to the outside world etc.

This article shows that the programs are very open to change and have been listening to their customers and allowed the childrens voices to be heard.  The kids are not saying they were abused but are asking for more input and control over their own lives and the process of healing them.



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