Posted by Joshua C. Doyle, M.Ed. on Mon, Jan 04, 2010
Oftentimes I meet with parents of an at risk child who know conceptually that some sort of intervention is required. However, their heart isn't there yet.
They want to believe that, because their child has not hit rock bottom at that point, there is still some hope. This, for instance, can hold true for a child who suffers from depression or other inward-directed emotions. If that child is physically present, parents can often convince themselves things will turn for the better because they can protect their child and are convinced that, as problem-solvers themselves, they can control the situation.
This is not always the case, however, for a child who is either overtly abusing substance(s) or is directing behaviors outward through defiance or rage. The problems *appear* much more acute and parents can feel as though they have no other choice but to act.
In the former case, if a child is spending 14 hours per day gaming on the Internet, the parent may rationalize that at least that child appears happy and is engaged in something seemingly innocuous. Similarly, the child who is severely depressed and doesn't want to leave the home may make the parent feel that the only place he/she feels "safe" and "wanted" is home under their care.
The sad truth is that, more often than not, parents are enabling their children because they fear loss of love as a consequence of intervening. A child can often falsely empower parents by appealing that he/she will never be happy leaving home and that trust and understanding is at stake. Unfortunately, this empowerment is really just masked manipulation.
Needless to say parents want their children to love them... however, the cost of wanting their children to love them while they are suffering pales in comparison to the devastating costs associated with losing them in the long run.
So, when parents ask in exasperation, "Will my child ever love me again?" my answer can be hard for them to hear. I explain to them that their child will in all likelihood make it clear to them up-front that the answer will be no... today. However, over time as healing takes hold, those parents will eventually see the longer-term gains of building a love that perhaps did not even exist at that level before.
Let us know what you have experienced...
Posted by Leslie S. Goldberg, M.Ed., CEP on Mon, Nov 09, 2009
Throughout my nearly 24 years as an educational consultant, various diagnoses have been known as the "diagnosis du jour" and yet one stands out as having been around for as long as I have been in practice... Bipolar disorder, which for years was known as manic depression only diagnosable in adults, is a mood disorder now understood to be present in children and adolescents. The presenting behaviors and symptoms, typically seen by both clinical psychologists and psychiatrists, are disruptive to school and home life and can tear a family apart as the symptoms become more pronounced.
When children's rage behavior, self harm, and extreme mood swings are at the point that the family simply cannot continue, a residential placement is sometimes the best way to deal with diagnosis and treatment. There are specialized short-term placements lasting approximately 6-10 weeks where the children and adolescents can be assessed and most importantly observed in a controlled setting day and night, 24/7. Very often insurance can help cover much of the costs of such a placement, although one can never guess which insurance plan will cover anything these days!
There are programs for young children as well as adolescents and young adults, with individual therapy, group therapy, and continued schooling in a structured and caring setting with experts called in as needed. In many cases, these extreme types of behaviors would rule out the use of outdoor therapeutic wilderness programs, and yet most of these diagnostic and treatment programs offer recreational activities as well as sedentary ones so that the health and well-being of the patient is assured. As the diagnosis and treatment plans become clear, and the patient is stabilized with a medication regimen as needed, the next step is discussed with the team, which would consist of the parents, the treating professionals, and sometimes the patient, if appropriate. The next step could be returning home with wrap-around services to continue the growth of the patient, or it could be a therapeutic day or boarding school.
The fear of the unknown is far worse than the reality of coming up with a wonderful solution to a frightening family problem. Let us know what you have experienced in either helping a family member cope with bipolar (or any type of mood disorder, for that matter, including bipolar II, cyclothymia, etc.) or in treating patients with bipolar as a clinical professional.
Posted by Leslie S. Goldberg, M.Ed., CEP on Sun, Aug 23, 2009
When parents call for help with a child, adolescent, or young adult they are often in crisis and we first and foremost need to determine if we are the right people to assist them. Do they need crisis intervention; do they need a therapeutic wilderness program; do they need a therapeutic boarding school or a residential treatment program; or do they need a young adult program? Do they need a medical facility? Do they need an intervention? Some families may just need to hear some local resources, wherever they are, if they cannot afford to place their child. Do they need some advocacy services to assist them with funding or IEP issues? Once we have tweaked out that kind of information and if they agree to engage our services, we do all of our due diligence and come up with a plan.
Sometimes the plan involves a two-step process with a short term program for a couple of months followed by a longer term school or therapeutic program. Parents are extremely eager and anxious to know all that they can and want to know the long term plan right at the beginning. More often than not, we cannot give them the long term plan until the shorter term program along with clinically sophisticated testing and the 24/7 observation, therapy, and assessment are well underway. Sometimes I really wish I had a crystal ball, but without the weekly calls and reports as well as the careful and thorough test interpretation, the view from that crystal ball may not even be accurate!
We acknowledge that this can be very difficult for parents. Therefore, we do everything we can to help them with this rationale. Although it would certainly be easier for consultants and a heck of a lot less work to come up with the two step process at the beginning, it is not always in the best interest of the child, adolescent, or young adult, and that to us at the Goldberg Center is the most important goal.
Let us know what you think...
Posted by Hannah Cleveland on Tue, Aug 04, 2009
While examining the anatomy of our educational consulting intake calls, I have noticed two disturbing trends in the therapeutic placement domain.
First off, the average age of the potential client is on the rise. We are hearing from an increasing number of families seeking help for kids who are 17 and older. Laws as they are, there is a very small window of opportunity to get struggling students the help they need. Parents are often referring to this as their last chance, yet it is the first time they have sought a therapeutic placement.
The other alarming educational consulting trend is an added layer of alcohol and substance abuse on top of the mental health issues we often see in our intakes... and it appears that hard drug use is becoming more of an issue.
What factors are contributing to these educational consulting trends? While the state of the economy is causing many people to hesitate, those who are approaching the age 18 threshold with children are driven to finally act.
Why the hard drugs in these dual-diagnosis cases? One can only surmise. On one hand, upwardly skewed ages could be yielding greater access to these tougher drugs. Perhaps tough economic times drive experimentation of the ‘street drugs.' Or maybe, once again, we're just seeing those cases that have culminated to a point beyond where they normally would in better economic times.
If you are a practicing professional, we would love to know if you are seeing similar trends, and if you have any thoughts on the matter...
Posted by Joshua C. Doyle, M.Ed. on Thu, Jun 11, 2009
During my years directing Admissions at a boarding school for adolescents with Learning Differences (LD), I received hundreds of frantic calls from parents whose children had just been diagnosed with LD and were looking for an immediate school placement. Yet, as I started to ask more questions, I often found that a good portion of these children also presented with clinical levels of depression, anxiety, substance abuse, and behavioral problems.
It was with a heavy heart that I had to tell the parents of these students that, although the school that I represented was designed to assist adolescents with LD, but due to their child's additional emotional/behavioral issues, I could not offer admission.
These parents would immediately respond...
"You don't understand, Mr. Doyle!!!! The Psychologists told us that our child's situation is a direct result from the frustration suffered from not getting the help needed to deal with their LD. If we get our child into your school, they will get the help that they need and everything will be fine."
Knowing the raw emotions behind their pleas, it would have been of no help to engage them in a spirited debate. I had to stay firm and explain that we, as a school, would be doing a disservice to their family if we enrolled their child because we did not have the expertise, nor the appropriate resources, to address all of their child's needs. Despite my best efforts, the phone calls often ended with tearful, enraged, defeated-feeling parents.
Countless studies have shown that individuals with LD are at an elevated risk for substance abuse, depression, and delinquency in comparison with their non-LD peers. In more cases than not, many of these LD individuals in crisis did not know they had LD until they were backed into some corner.
When a student acknowledges the existence of LD, it can bring to light a lot of the frustrations experienced over the years. Unfortunately, this new realization cannot turn back the clock and immediately provide relief from other coexisting issues. The emotional/behavioral problems have migrated to the forefront one way or another and now need to become the primary focus of treatment.
Private boarding and day schools for students with LD offer a supportive and nurturing environment that can often help a "fragile" child or adolescent to remain emotionally and behavioral intact. However, this nature and intensity of support and nurturance is not enough to address emergent emotional/behavioral issues. In most of these types of cases, LD Boarding and Day schools for adolescents with co-morbid issues are often not appropriate settings.
Therapeutic Boarding Schools and Residential Treatment Centers can often make academic accommodations for students with LD. However, these accommodations are often not nearly as effective as the academic programming in LD school settings. In some cases, students who attend these therapeutic settings can later attend a specialized school in order to then address the underlying LD issues, but by then they have typically lost a lot of opportunity in the developmental cycle.
So, where does this leave you as a concerned parent? Damned if you do, damned if you don't? Fear not, there are steps you can take; they just need to be more deliberate, more calculated at this stage. You don't have much room for error.
Some Suggestions:
1. If at all possible, do not wait to intervene. Time is not on your side. There are resources you should access whether or not you are planning on changing schools. All research studies show that the earlier the intervention, the better. LD issues do NOT go away on their own.
2. Evaluate or re-evaluate your child ASAP, so you can distill the extent of the emotional/behavioral issues that have manifested alongside the LD. You will need to have a testing practitioner (neuropsychologist/psychologist) administer specific assessments that probe for emotional/behavioral issues.
3. Stop blaming one set of issues on the other. The bottom line is that both exist and need to be addressed as soon as possible.
4. If you are even considering changing schools, make sure you open your scope to those that can work effectively within both issues - the LD and emotional/behavioral struggles. BUT, you also want to keep the balance in check so as to avoid the "catchall" options that claim to treat anything and everything. There are some wonderfully targeted options that achieve the right balance for you.
Posted by Leslie S. Goldberg, M.Ed., CEP on Fri, May 29, 2009
We have spoken about therapeutic wilderness programs and how effective the good ones can be, but why isn't that enough? What if a family can't financially swing both wilderness and aftercare? What if the child or young adult has conditions that preclude the referral to a short term outdoor program or even a short term diagnostic program that is not outdoors? What is the difference between a residential treatment program and a therapeutic boarding school? What about transition programs and "regular" boarding schools? Where do all of these fit in our world?
There is such confusion about the nomenclature because the licensing differs from state to state, but for our purposes here we will include small residential programs that are highly clinical as well as larger sub-acute facilities when describing a residential treatment center (RTC). RTCs offer similar care and therapy to what used to be lengthy psychiatric hospital stays years ago before managed care took those away. The respected RTCs of today are wonderfully nurturing, have psychiatrists working with the students on a regular basis (most on a consulting basis) and the emphasis is on individual, group, and family therapy although each has an accredited school as well. The way I differentiate these from the next level down (often called therapeutic boarding schools) is this overly simplistic way:
- RTC or similar programs typically have a 75% emphasis on therapy and 25% pm academics
- Therapeutic boarding schools (sometimes referred to as emotional growth schools) typically might have an equal emphasis on therapy (50%) and academics (50%)
- Transition or step-down programs may have 75% emphasis on academics and 25% on therapy
- Traditional or mainstream boarding schools who might be likely to consider students after a therapeutic setting of any kind would not have therapy as part of their program but may have therapists nearby in the town or consulting to the school.
But how do we know what kind of school or program our child needs? There are many ways of determining the needs of our kids. A really good complete neuropsychological or psychoeducational evaluation that includes projective and personality testing is one piece. Another would be the use of an instrument like our in-house Goldberg Educational Placement Inventory (GEPI) as well as speaking to the professionals who have worked with the adolescent or young adult, as well as a face-to-face meeting if appropriate. Often a short term intervention like wilderness offers amazing insight into the needs for the next step.
This is a very basic explanation of the "lay of the land" in the world of the therapeutic settings. Should you need more information please call and set up a phone call with one of us at the Goldberg Center. If you would like to share your perspective, please leave a comment...
Posted by Joshua C. Doyle, M.Ed. on Tue, Apr 28, 2009
Parents often hope that all of their struggling children's problems will simply vanish upon enrollment in specialized schools or programs. Frustration therefore tends to mount early in the process since most families have had to make enormous personal and financial sacrifices in real-time to get their children the most appropriate help available. So, despite the build-up of many, many years leading to their children's struggles, parents want to see a quick return on investment in the form of significant change in academic and personal development.
Typically, children come home to visit during a holiday or school break and complain how they do not want to go back to their specialized schools or programs. They try to their best to wear their parents down to the point that the parents' hope for a "new relationship" with their children seems impossible. Rather than gratitude, they only receive gut-wrenching guilt-trips.
And then, during subsequent phone calls, these students may embellish stories or even fabricate disturbing scenarios to send their parents over the edge. There is nothing more difficult for parents than to sit on the other end of those phone calls, especially as they are so far away, so detached from what their children are experiencing. They feel completely powerless, especially as the stakes seem so high in those moments.
Advocating for struggling children in specialized schools and programs feels like a full time job. Oftentimes, parents put their own needs on the back burner during that time and suffer dramatically. Friendships are neglected, pastimes abandoned, marriages challenged, and other children's needs are overlooked.
So, how can you as parents find some relief and entrust the professionals at these specialized schools and programs to enable the real work to progress? And how can you simultaneously avoid hindering that progress by micro-managing your child's treatment or education?
1. When you get a phone call from your child about an incident, say to them "I know you are upset but you need to speak to a staff member about this." The greatest skill a parent or school can teach their child is "self-advocacy." This will prevent your child from thinking he/she can embellish or manipulate you. It is important that your child knows that you are supporting the school; if you come off anxious or disenchanted, he/she will exploit that. No school or program is perfect, but the good ones know how to manage expectations and work with you to establish a common platform from which to work collaboratively. Here's where educational consultants can help significantly as well... we're really good at helping you differentiate between an issue with your child and an issue with that specialized school or program.
2. If that specialized school or program has a parent mentoring program, take advantage of it. The struggles that engulf you while your child is getting help can leave you feeling very isolated. Sympathy from friends and family is often NOT enough. They likely cannot relate. Empathy and support from others who have had a similar experience will aid you through the process in a way you cannot even imagine.
3. Treat yourself to guilt-free pleasures. Reconnect with your old friends and re-engage prior passions. Spoil yourself on occasion - you need to go on living even if it is tougher to do so under the current circumstances.
4. Seek counseling. It is unreasonable to think that you will be able to get through this process unscathed. Optimally you should work with a practitioner who is both supportive of and familiar with the impact that a specialized school or program can have on your family system.
Leave a comment and let us know what you have experienced either as a parent or a professional.
Posted by Leslie S. Goldberg, M.Ed., CEP on Wed, Apr 08, 2009
A generation or two ago dads went to work, moms stayed home and kids lived in fear of adult reprimands and punishments. Today, with so many fragmented families, both parents working, and the expectation of immediate gratification, the parents have become more enmeshed with their children's lives. At the same time, we, as specialized educational consultants, see more teenagers acting out as well as in and needing structure rather than "stuff" like electronics, the latest fashions, and attitudes.
Perhaps out of guilt, perhaps due to giving their children what they feel they didn't have, the parents are joining in on their children's games, social life, even drugs. Today's teens are often called "entitled" and feel as if they can have whatever they wish and it is the parents' job to get it for them. As a specialized educational consultant for nearly a quarter century, I have watched parenting trends come and go along with the "diagnosis du jour" whether it is ADHD, Bipolar, borderline, or Aspergers. Parents are looking for answers, diagnoses, medications, quick fixes when very often if they just said no it could work miracles!
Therapeutic boarding schools and residential treatment centers allow minimal amounts of clothing, electronics, and "stuff" and the students' rooms are kept tidy every day. There are clear rules and consequences around academics, residential life, and extracurricular activities. As parents we could learn some lessons from this by setting very clear rules, boundaries, and expectations with clear and consistent consequences when the teens do not step up to the plate. Of course, in a perfect world, all of this should start when the children are toddlers.
As specialized educational consultants, we often have to tell it straight - befriending your kids now can ironically alienate them in the future... and for a considerably longer duration. You need to specialize as a parent, not a friend.
Leave a comment - let us know your thoughts, your observations, your insights.
Posted by Nina Flood, M.B.A. on Thu, Mar 12, 2009
If you have had the challenges of finding, placing, and paying for educating and/or treating one of your children for his/her special needs, you know that this process is not something you wanted or chose. As such, you DO want to tell the financial aid office(s) at the college(s) of any of your other children.
Financial aid calculations strive to equitably allocate federal, state and institutional aid based on income and assets, but you can appeal based on certain non-discretionary expenses. Track and report all associated medical and dental expenses in excess of 4% of your income, (report on schedule A of the 1040); your tax professional can advise as to which expenses may here qualify.
Additionally, document and provide the costs at residential, day or other education/treatment institutions. The Profile, (the College Board's form for many private institutions) does ask about private secondary tuition, but a college may choose whether or not to take that into consideration. I have not known of a school not taking special needs' costs into consideration to reduce available income for the calculations.
If the Profile is not required by your child's school, write an appeal letter with documentation, (assessment, diagnosis, and costs), and send to your child's financial aid counselor. DO NOT go directly to the Financial Aid Director, as this usually slows the process.
If you have any questions, feel welcome to contact me directly. We have built out a virtual financial aid consulting center, where I have just gone live fielding questions on-line for free.
Posted by Adam Goldberg on Sun, Feb 15, 2009
What should you look for when reviewing schools for troubled teens? There is so much marketing and hype in the troubled teens arena that you need to look beyond the thin veneer of web sites, brochures, and even pyramid schemes.
Consider this - if you are in the throws of crisis with a struggling teen, you are typically not thinking straight for starters. Add the fact that you have probably never considered options of this nature and you have a recipe for high risk in your decision-making.
Fear not. The following is a starter's guide to reviewing schools for troubled teens, including therapeutic boarding schools, residential treatment centers, and even therapeutic wilderness programs. Asking the right questions ensures lower risk and better chance for success:
- Who owns the school or program and how is it funded? Before anything, you need to assess the health of the business and the reputation of the leadership behind it. In a way, it's not so different from performing due diligence before buying a stock; only, the stakes are higher. If there is a parent company, what is it and how does it operate? What are the backgrounds and goals of the management team? Are they transparent about their business practices and financial health? Are the founders still in the picture? What is the vision moving forward and how has it changed since its foundation? Both your research and your gut need to steer you with this, the most important piece of your investigation.
- Is the school or program accredited? By whom? For what? Remember that therapeutic schools and programs have a clinical, educational, and residential component, each with different prerequisites and standards. For example, while a residential treatment center may be JCAHO-accredited, it may not be credentialed as a diploma-granting educational institution in its state of operation. Don't make assumptions.
- How is the student population comprised? Do the students all present with similar issues or do they span a myriad of diagnoses? Are most state-referred or paying privately? Are most referred by educational consultants? Are the families those to whom you can best relate? You want to feel like you have a peer group yourself when going through this difficult phase.
- How is treatment administered? Individual therapy? Group therapy? Both? How often? What methods? Who are the clinicians and what are their credentials? Are there specialists on staff? How is medication managed? Make sure you understand and support their methods of care.
- Are the physical characteristics of the school or program reflective of the level of care proposed? Look for the risk points. One time I couldn't help but notice the omnipresent drawstrings [on window shades, laundry bags, etc.] at an RTC that specialized in treating suicidal teens. Hmmm.
- What is the method and frequency of communication between you and the school or program? Do you have a weekly call? Is email used? Video conferencing? How are you updated? How are emergencies communicated? How should your educational consultant figure into the mix if you have one? Communication or lack thereof seems to be the biggest point of contention for parents post-enrollment.
- How are tuition and fees structured? Per diem? Per month? Annual? What might insurance cover? Any incidental charges for supplies, equipment, etc.? Any opportunities for scholarships or discounts?
As you can see, there is a lot to consider. While this questionnaire is not exhaustive, it is at least a guide to get you started in the midst of your frustration, confusion, and angst. Chances are very good that you will make much better informed decisions if you ask these questions when venturing out into the wild world of schools for troubled teens.