Placing the Right Child in the Right Facility for the Right Reasons

“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.