Teens entering residential care are often impulsive, angry, guarded and anxious. Of course when they arrive they are now living among other teens with similar feelings and at varying stages of development. Verbalizing their fears in healthy ways is often beyond their ability for at least a few weeks. Any questions regarding their behaviors early on in treatment seems to only intensify feelings of guilt and shame and initiate defensiveness. It often feels like any attempts at therapeutic interventions at this stage will be inadequate and even counterproductive. Earlier on, teens tend to be highly resistant to developing relationships with staff and peers and are hyper vigilant in blocking any type of approach.
The only way to break through the tough veneer is to demonstrate a deep level of integrity. If properly demonstrated, integrity is able to exhibit reliability and honesty. The very presence of staff creates an impression that the main focus is on helping the teen, not on benefitting the adults. The culture of the entire program must show this posture of integrity in order for the teen to begin the process of lowering his or her guard.
Only a positive environment will give opportunity for change as well as reduce the risks associated with teen care during the journey. Of course, any program that is able to bring lasting solutions to troubled teens’ problems is also exposed to the potential of incidents. A positive culture will reduce risk and, in turn, increase the positive outcomes for youth.
In order to create a positive culture, there are many known factors that influence success. Here are a few of the most critical elements in any top-notch therapeutic program:
In order for students to gain new directions in their lives, the program must provide structure with constructive guidelines. Teens often feel out of control and anxiety only builds as fears of the unknown remain. A structured and consistent program allows parents and teens to have realistic expectations. But the program also needs to be flexible – too much structure can be as detrimental as too little. Choices must never be negated by routine and order, for it is through choices that learning may occur. Even though most students arrive reluctant and resistant to counseling and the prospect of change, they must sense that the program is capable of helping them change. To be motivated to change, one must at least believe personal change is possible within the environment.
Staff skill development plays an important role in any quality program. Barbara F. Okun noted in Effective Helping (1982) that there are five characteristics that caregivers on any level should possess: self-awareness, honesty, congruence, ability to communicate, and the knowledge of how to establish rapport and build a positive relationship. These are skills that staff in every position of the treatment facility should possess in order to establish a deep connection with teens. Effective nonverbal and verbal communication is the path to establishing rapport. Seeing the world from the student’s point of view might only be the first step, but it is critical. This understanding must be communicated; then trust that develops through feeling safe can be established. Staff and youth alike must have a sense of belonging, value, being treated with respect, dignity and acceptance. There must be freedom to make mistakes, to forget, and to ask for help.
Relationship-building skills in residential treatment programs most often start with managing conflict. Conflict is inevitable in therapeutic programs that work with struggling teens. Well-trained staff is able to avoid power struggles and turn conflict into a meaningful growth experiences. Quality staff knows how to stop, listen, identify the problem and allow the teen to develop solutions. They actually hunt for win-win solutions by involving the youth in decisions and exploring some choices and consequences.
We expect our staff to be firm but friendly, definitely not aggressive and most importantly, to separate the behavior from the youth. Staff skills must include the ability to control negative emotions (especially their own) and avoid escalating the situation whenever possible.
Effective communication is not only a method of disclosure, but also a path to discovery. Effective listening will broaden a youth’s view of himself and the world around him. This type of really engaged ‘active’ listening requires strict attention and the ability to be objective in situations that will often evoke strong opinions and judgment. Listening at this level demonstrates a true willingness to be part of a meaningful exchange and instead of just confront. According to Bowman (et al., 1998) good active listening is being able to encourage, clarify, restate, reflect, summarize and validate.
Good quality therapeutic programs understand how to create a positive culture. In spite of working with resistant students, Shelterwood has always found a way to help their students lower their walls and open themselves up to their great potential. The teens we get to work with have tremendous gifts and abilities that often lay dormant under the heavy weight of self-doubt and fear. Helping our teens uncover their true identity is a truly rewarding experience for us all.