How Do I Know if Out-of-Home Placement Makes Sense

by Dr. George Posner

In most placements the process through which the parents must pass is as crucial to the success of the placement as the process through which their children must pass, in some cases even more crucial. Just as their children progress through specific phases in their growth process, so too do their parents. These phases are important for the consultant to recognize, since the consultant must often help the parent through them, if the placement is to have any chance of success. If the consultant attempts to push the process too fast or to ignore a particular phase, he or she risks the parents derailing the placement: discontinuing the placement process; "rescuing" their child from the program; or undermining the program by communicating their lack of commitment to graduation from the program. Although these disruptions are always possible, the risks greatly increase if the parents do not get help in working their way through the phases. Drawing on 31 years as an educational researcher, 12 years as an educational consultant and 4 years as a Hyde School parent, I have found it useful to think of the phases through which parents must pass as a series of realizations. Each realization itself takes place over time as the person progressively internalizes it. This internalization process, stated simply, moves from the head (understanding what needs to be done), to the heart (believing in a course of action), to a commitment to act (ready to do it). The series of phases can be described as follows:

1. Realization that a problem exists. Overcoming denial is the first phase. It can be triggered by a range of potential precipitating events, including falling grades, parents learning of a child's sexual acting out, verbal or physical abuse of a parent, suspension from school, running away from home, attempted suicide, or arrest, among others. A particular event or set of events, will function as a "turning point" if it moves the parent from denial to the realization that a serious problem exists. Of course every parent has his or her own "turning point." This phase involves not only seeing the behavior, but also realizing that it is neither "normal" or O.K. (just because others are doing it) and that the child will not necessarily grow out of it (and may even die from it). Helping a family move from understanding that a problem exists, to a sense of readiness to act can be difficult. I have found that the consultant can be instrumental in this process by asking the parents the question, "What exactly are you waiting for?," then waiting for a response, and then finally replaying their answer back to them.

2. Realization that home is not necessarily the best place for the needed changes to take place, and may even be part of the problem. Children typically resist leaving home, younger children because of their attachment to their parents, adolescents more because of their attachment to their peers. Parents resist sending their children to a distant program due to guilt that they have failed as parents, their own need for companionship, and their need to nurture their child. Parent support groups can be crucial in helping parents move successfully through this phase.

3. Realization that the problem is serious enough to warrant a major disruption in the family's budget. Treatment programs, schools, transportation, and evaluations all can represent an overwhelming expense, even for those who can afford them. And since no program or school can guarantee results, the parent may have grown so disheartened and disgusted that desperation has turned to hopelessness and pessimism. These two factors, costs and the lack of guarantees, can interact to become a major obstacle to taking action. I have found it possible to overcome this obstacle with an analogy: Suppose your child had cancer and I told you that there was good news and bad news about it. The good news is that the disease is treatable and that treatment is often successful. The bad news is that the treatment will cost a lot of money and that there are no guarantees. Would you say, "Wait. I'm not sure I want you to treat my child."? Well, your child has cancer of the soul and it could kill him if not treated. However, it is treatable, but it will cost a lot and is not always successful. So, what do you want to do? Sometimes I have pointed out that younger siblings are watching how the parents are dealing with the problems and that decisive action may prevent future problems with siblings, regardless of success with the child who is acting out.

4. Realization that it will take a long time before the child can come back home. Everybody would love a quick fix. Even if parents don't expect it at the outset, once they see their child act "normal" within a program and the memory of the crisis begins to fade, the parents can relapse back into denial. Maybe the problem was not so bad after all; maybe they acted too quickly; maybe the child can come home now. This is the time when parents who are not prepared typically pull their child out of the program or renege on their commitment to follow up a short-term program with a longer-term program or school. They need to realize that one to two years of treatment is a short time compared to the amount of time during which the problems were developing. Commitment to graduation from the program is essential before the placement.

5. Realization that they as parents played a role in the development of problems and that they are crucial in order to work through the problems successfully. In matters of character there is no way of escaping the fact that parents are their children's primary teachers. Durable changes in children (i.e. changes that last once the child leaves the school or program) require serious family work. Again, parent support groups, commitment to family counseling, and parent attendance at Alanon are often important steps for parents to take. The consultant should help parents realize that the time during which the child is away from home is an opportunity for parent personal growth, rather than just time to feel guilty or for parents to escape their problems (e.g. spending more time at work). The consultant can try to help parents avoid getting stuck in guilt, but, at the same time, accept responsibility for their roles in the family dynamics. Then the next step becomes moving them to take some steps in changing those dynamics. For a child finally doing well in a program or school, a visit (or vacation) home may well be more a test of the family's progress than a test of the child's. How to make the connection between program and home seamless represents a major challenge for any family. This phase is often the most difficult. Each parent moves through these 5 phases at his or her own pace, often getting stuck at a particular phase, unable to progress on his or her own. It is at these points that leadership needs to emerge in the family. Without leadership the family languishes or, worse, spirals downward. It is difficult to predict where leadership will emerge. The mother, who has been accused of being overly emotional may be the only one who is finally willing to act on the basis of her conscience, even if her action creates disharmony. Or the father, who has been overly rational, analytic and emotionally inaccessible, may be the one who pushes the family to make fundamental changes in the way it functions. Occasionally the out-of-control child, once he or she is out of crisis, emerges as the leader in the family. People outside the immediate family, such as grandparents or an adult brother or sister, might even take on the leadership role. And leadership may shift from one family member to another as each person progresses at his or her own pace through the phases of growth. The consultant, because of the need to maintain professional distance, can never lead the family members through the phases of growth, but can act as a catalyst for these changes: by asking questions, challenging invalid assumptions and beliefs, sharing personal experiences, encouraging phone calls to other parents, and lending reading materials.

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