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“When the Moon
Hits Your Eye Like a Big A Pizza Pie, That’s Amore”
Placing the Right Child in the Right Facility for the Right
Reasons – Jared Balmer, Ph.D.
Throughout most of my career, I have been involved in
residential care, ranging from foster homes to psychiatric
hospitalization and all the garden variety in between. A mixture
of providence and fate afforded me the incredible opportunity to
be involved in the creation and formulation of a variety of
programs, both day-treatment and residentially based.
As part of this process, innumerable hours were spent in writing
policies and procedures. However, the most critical thinking and
writing was always devoted to the CORE aspects of the program,
which included the development of the mission statement, and
primary goals and objectives, service philosophy, theoretical
foundation for treatment, description of the population served,
exclusion and a discharge criteria, and a rationale and
delineation of core therapeutic services upon which the change
process pivots. All other policies and procedures flowed from
this core.
Other considerations, such as staffing patterns, admissions
procedures, behavioral management techniques, and many others,
have to “wash” with this established core. If a program is
defined as a family, the core of the family would be the
parents. In a broader sense, the core is mother earth, the
planet upon which life is shaped.
Many programs, as a value-added feature, offer adjunct
programming. This may include elements such as spiritual
discovery or values-clarification groups, equestrian
programming, volunteer work and community involvement, sports
and recreation activities, technology-related and vocational
programming, or exotic excursions abroad. All such activities
are adjunctive in nature. They are not the core of the program.
They can certainly enhance the core. However, they are not the
core. If the core is represented as a planet, the adjunctive
programming could be represented as the moon circling the
planet.
Yet, some families considering placement look at the moon and
fall in love. Such romance is well and good if the child has
been placed for the core program offerings. However, this “moon
love” can turn into disappointment if the child is placed in the
program simply because the adjunctive program is so appealing.
Clinical placement decisions should take place from core planet
considerations, and not as a result of the attractiveness of the
moon. The core of a program must meet the child’s fundamental
needs. Whether a program has a ballet program, an equestrian
course or a particular sports program, can in no way be the
primary factor for the placement decision.
Is it possible for such “moon struck” placements to occur?
Absolutely. There are a number of scenarios under which
placement occurs with good intentions, but for the wrong
reasons. Some parents may feel guilty for sending the child away
from home. Trying to “ease the pain”, they may sell themselves
and the child on the notion that Johnny can be on the lacrosse
team, or Susie can travel abroad as part of her foreign language
curriculum offered at the program. In the minds of such parents,
the planet is no more important than its moon. Under this
framework if Johnny is unable to play on the lacrosse team
because of inappropriate behavior, the parents’ focus may be
upon the loss of lacrosse, rather than upon the core concern of
Johnny’s issue as they relate to his eventual success and
happiness in life.
Others bank on the hope that a value-added program component
will be the magic potion that will propel Susie in the change
progress. While this is entirely possible, to place a child for
that reason alone can compromise treatment success while setting
up the family and the program with unrealistic expectations.
Long before value-added programming becomes part of the
placement decision, there need to be assurances that the core of
a program meets the primary needs of the child, as defined
through a thorough review of clinical information.
Referring professionals can be invaluable in preventing parents
from getting “moon struck” in providing this sort of thorough
matching of a student’s clinical, emotional, and academic needs
with a program’s core offerings. Additionally, programs and
schools have an ethical obligation to communicate to families
the core of the program before showcasing the equestrian,
sports, spirituality components, or other such enticing moons.
With our feet set on this solid core, we all have a better
chance to enjoy the moonlight.
Dr. Jared Balmer, Ph.D. is the co-founder of The Oakley
School and Island View Residential Treatment Center. He
currently functions as the Executive Director of Island View RTC.
Dr. Balmer is a member of the Behavioral Health Advisory Board
of the Joint Commission of Accreditation of Healthcare
Organizations (JCAHO). Dr. Balmer has taught at several
Universities and has work with adolescents and their families
for over 30 years in a wide variety of settings.
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