The professional literature on adolescent development and programs for struggling teens suggests that, ideally, programs should have a number of key features. These principles should underpin any efforts to help struggling teens and their families along every point in the continuum of care, including initial assessment, crisis intervention, home-based services, community-based counseling, alternative community-based education, mentoring, drug and truancy courts, wilderness therapy programs, emotional growth boarding schools, therapeutic boarding schools, and residential psychiatric treatment. Parents of struggling teens, and the professionals who work with them, should seek to identify programs that embrace these principles, in addition to those presented in Parts I and II (principles 1-5).
Principle 6. Words matter. Staffers’ and administrators’ choice of words, tones of voice, facial expressions, and nonverbal cues shape the teen’s experiences in a school or program. “It’s not just what you say, but also how you say it” is the pertinent adage. For example, suppose a teen is suspected of stealing from a staffer. Adults might be tempted to bellow, “I’m sick of not being able to trust you! I’m sick of you! You’re a chronic liar and a thief. Get out, get out, get out!” While this verbal outburst is fully understandable, it may be preferable for the adult to say, “I need to be able to trust kids in my office. It angers me when my stuff is missing. When my stuff is returned to me and we’ve discussed what happened, you might be allowed back in here. Until then, you and I will have to meet in the lounge instead.” Treating teens with respect, even when their behavior is outrageous, models for them constructive ways of dealing with intense emotion, interpersonal conflict, and other problems. This modeling can be a feature of a coordinated plan for helping teens change their behavior.
Principle 7. Relationship matters. In fact, relationship is the essential vehicle for much of adolescent development. As the bumper sticker says, “Love and learning go hand in hand.” Brutal, disempowering, counter-controlling, coercive adult behaviors in programs and schools for struggling teens parallel, replicate, and model in a negative way the problematic behaviors of many struggling teens and therefore are unhelpful responses. That kind of response can exacerbate the problems that the struggling teen needs to address. Quality programs and schools recognize this dysfunctional dynamic. A teen’s manipulative, provocative, defiant, and noncompliant behaviors tend to provoke in many adults a perfectly understandable inner response of “How dare you! I cannot let you get away with that.” While certain, clear, firm, and fair consequences delivered in a timely manner are absolutely necessary, they must be administered in a way that cultivates a positive, warm, affirming, nurturing adult-teen relationship. When staff behaviors toward the teen are manipulative, dishonest, controlling, and disrespectful, a healthy adult-teen bond is eroded. The program or school milieu becomes counter-therapeutic.
Positive treatment of teens by staffers is possible only when colleagues, administrators, and supervisors offer positive, warm, nurturing, and supportive affirmations to front-line staffers. Working with struggling teens is demanding, challenging, and often difficult. At times the patience of staffers will wear thin. Teens’ struggles inevitably will trigger a staffer’s personal issues. Emotions may flare. Staffers need to know that before they have “had it,” they have an emotional and logistical escape hatch. A program or school should never be short-staffed; caregivers who are at their wits’ end should have access to respite and be able to cool off. This is a wise abuse-prevention measure.
Nurturing the staff means that employees too are treated respectfully and professionally. Newer staffers may need more frequent, attentive support and supervision than veterans. All staffers need to know that their reasonable mistakes will be handled as learning opportunities, not character flaws. Similarly, as with the teens, administrators will enunciate clear, firm, certain, and fair consequences for staff misbehavior and positive reinforcement for desired behavior.
Principle 8. Size matters. Smaller schools and programs generally can provide more personalized, individualized attention and close supervision and monitoring. Regardless of staff-to-teen ratio, a program with forty teens obviously is in a better position to pay individual attention than one with 180 teens, where a teen can more easily blend into the woodwork. For-profit programs and schools may have a compelling financial incentive to accept larger numbers of teens in order to enhance revenue by capitalizing on economies of scale. In smaller programs the staff is more likely to be able to control the “contagion effect,” whereby peers negatively influence one another.
Some larger programs (such as conscientiously run wilderness therapy programs) only use small groups for the teen’s entire stay. The teen is never with more than six to ten teens at a time. Hence, the total number of teenagers in a program may not be as important as the amount and quality of attention the teenager receives from consistent caregivers who spend time with the teen and truly know, understand, and have a positive working relationship with the youngster.