Stopping the Madness: Alternatives to Hospitalizing Children and Teens
Aaron was only nine but had already been in psychiatric hospitals three times. "We felt like we had no choice," says his mother, Lisa Thomas*, of New Jersey. "He was so out of control. He had rages that lasted hours, he wouldn't go to school, and on the rare days that he did, he would spend most of his time throwing up in the principal's office."
Aaron is diagnosed with ADHD, bipolar disorder and anxiety. When medication, weekly therapy, and even intensive daily therapy didn't work, the Thomases followed the advice of Aaron's psychiatrist and admitted Aaron to a regional hospital offering inpatient psychiatric care for children. "We thought the hospital would stabilize him, get his meds sorted out and give us our boy back," remembers Thomas. Instead, Aaron was discharged three days later. "They started him on new meds that wouldn't even start working for a few weeks. His separation anxiety was worse than before and he was so embarrassed by the hospitalization, he wouldn't leave the house."
The Thomases aren't alone. From 1996 to 2007, the rate of psychiatric hospitalizations rose by more than 80 % for 5 to 13-year-olds and by 42 % for older teens1.
The Thomases wanted an alternative. "I've heard people say that the definition of insanity was doing the same thing over and over and expecting different results," says Thomas. "Well, that was us. We kept sending Aaron to the hospital, expecting that this time he'd get better. This time we'd get the meds right. This time he'd come home and be okay. But he wasn't."
"We started searching for other options on our own, but were quickly so overwhelmed with our choices," says Thomas. "My husband and I had no idea if Aaron needed a wilderness program, a regular boarding soon, a therapeutic school, or a residential treatment center. It was information overload."
After reaching out to parents she met at a support group, Thomas and her husband called an Independent Educational Consultant who specialized in kids like Aaron.
Independent Educational consultants (IECs) help families locate schools and programs that are a good fit. IECs work with families in crisis and find suitable solutions for kids with oppositional behaviors, learning disabilities, ADHD, mood disorders, autism spectrum disorders, substance abuse and more. IECs are paid by their clients and never by the places have they referred children to. According to the Independent Educational Consulting Association, IECs typically spend 20% of their time visiting and evaluating schools and programs.
And it pays off.
"Aaron just started his second year at the boarding school our consultant matched us with. The difference in him is amazing," says his mother. "He is happy, motivated, doing well in school. He is off his med 'cocktail' and only takes one medication for attention now." Best of all, Aaron has not returned to the hospital. "He's climbing trees, joking with his buddies and reading Harry Potter. That wouldn't have happened without this school."
A quick glance at the National Association of Therapeutic Schools and Programs (NATSAP) www.natsap.org website reveals over 150 schools and programs - from boarding schools for young boys like Aaron to wilderness programs for out of control teens.
"An educational consultant plays an invaluable role in the search for alternatives to hospitals," says Mark Sklarow, Executive Director of the Independent Educational Consultant Association. "There are so many options available for a wide range of issues. There's also a wide continuum within the programs themselves. Many programs are extremely effective, but some shouldn't even be operating," he says. "Only someone who specializes in these places, who has visited and talked with directors and therapists, can possibly know which is the best match for a family in crisis."
The Conswack* Family of Austin, Texas, couldn't agree more.
"Melissa was your typical girl next door. She had nice friends in the neighborhood, she did well in school and played on our town's soccer team," says her mom, Sheila Conswack. But at the end of ninth grade things changed. "It was your typical downward spiral. Her peer group changed, she stopped doing school work and sometimes didn't even make it to school, " says Conswack. But, conventional interventions didn't work. The Conswacks tried grounding Melissa, they hired a tutor, they went to family therapy and had Melissa evaluated by a psychologist. "I felt like we left no stone unturned and it wasn't helping."
Melissa's 17 year old brother, Doug, gave the family the reality check they needed. "She's turned into the kind of girl you wouldn't want me bringing home," he told his parents. Doug filled them in on the alcohol and marijuana use and the promiscuity.
"Basically, he gave us a laundry list of all her misdeeds, and we were scared," says Conswack. "I remembered hearing through a friend that a neighbor's son had 'gone away' for similar issues and was now happily attending a good college. So, I called her and she gave us the name of the program her son went to and the name of the educational consultant that had found the program."
After much deliberation, lots of tears and arguments, Melissa went to a Wilderness Program where she spent ten weeks living primitively, focusing on her behavior and learning how to handle issues within her family. "At first I was dead against it," recalls Conswack. "I thought it was going to be a boot camp where she would be mistreated, but it was actually completely the opposite." Melissa's program was headed by PhD level psychologists, who did one on one therapy with the students, ran groups and helped the teens make life changes. "Believe it or not, Melissa actually thanked us at graduation. She said we saved her life."
After graduation, like most teens who complete a wilderness program, Melissa enrolled in a therapeutic boarding school. Therapeutic boarding schools emphasize academics like traditional boarding schools, but also support the student's social and emotional issues, usually through a structured daily program and individual and group therapies.
For some struggling teens, a therapeutic boarding school may not be enough. Residential Treatment Centers offer a higher level of care than boarding school and are suited for more psychiatrically involved cases. While academics are addressed, the main goal of RTCs is to help the student gain control of their behavior. There is typically psychiatric care onsite as well as intensive group and individual therapies.
"Boarding school was our last resort," says Thomas. "I only wish it would have been our first."
*Names and identifying information have been changed.
1. Joseph C. Blader, PhD Arch Gen Psychiatry. Published online August 1, 2011. doi:10.1001/archgenpsychiatry.2011.84
Lucy Pritzker, MS, is an Educational Consultant who finds the right schools and programs for children and teens with special needs. For a prompt response please contact Lucy at 908/370-8021.