Powerful Insights from a Family in the Residential Treatment Process

Sometimes, you run across something so insightful that it moves you and inspires you to self-reflect.  I had that experience this past week, when an email from the grandparents of a girl in one of our programs was forwarded to me.  With their permission, I wanted to share their thoughts about the experience they just had with you, while withholding the names involved.  Also, by way of explanation, our programs have Parent Seminars every three months where parents (and many grandparents) travel to the program to be with their daughter for several days.   There they do family therapy together, participate in therapeutic activities, share with fellow parents at a parent support group, and just have fun.  These grandparents had just completed one of these weekends which prompted the following email from them:

So that you might know how beneficial the weekend is, I wanted to share with you some of my personal insights from the  weekend.  I found that the opportunity to share with other parents was very insightful and enlightening.  In visiting with other parents,  I had a sense that all parents, myself included, most commonly expressed frustrations and disappointments before coming to Moonridge. These frustrations seemed to be rooted in expecting too much of our children.  It is good to set our standards high but only if we, as parents, are prepared to serenely accept results that fall short of our expectations.  When not prepared, expectations become premeditated resentments toward our children.
Our goals are not always their goals. Our values are not always their values. They can not live a life that they do not subscribe to.  We somehow arrogantly believe that ours are right and theirs are wrong. We don’t always grant our daughters the dignity to be the unique individual that they  are.
Perhaps as parents we are more in love  with ourselves….with the daughter we want….than with the daughter we have.  When parents come to this point with humility that humility releases them from the bondage of self…pride, arrogance, prejudice.  I fear that the parents there, including myself, universally expected more out of their daughter than a sick confused girl could deliver. Similarly I believe that there may be an expectation, once well, of a complete transformation of their daughter.  Instead, to avoid premeditated resentments, I think we parents should seek progress and not perfection.  I think a pivotal change that needs to occur in the parents is to learn to settle for less than they wished for and to be willing to accept it and appreciate it.  Contentment comes from accepting gratefully the good that comes to us and not raging at life because it is not better.  This good attitude is not resignation but realistic acceptance of what life sends our way. We parents, perhaps more than our daughters, need to change.
Parents need to acknowledge that they are not in control and that the only thing they can control is what is inside their skin…themselves.  If our daughters are going to change, it is up to them and not to us.
We need to turn not to ourselves for solutions but to our higher Power.  We need to accept life on life’s terms.  I am reminded of the Zen proverb that says, “When I understand it, it is what it is.  If I don’t understand it, it still is what it is”.  I felt so upbeat because I perceived that every parent wanted to change because every parent there loved their daughter. Hence I saw hope burning brightly. The most important dimension for change is to be willing….and every parent was willing…..that is why they chose Moonridge.  Its program is designed for both. Thank you for your foresightedness!!
We look forward to the next weekend.  We will come with an upbeat heart and a teachable spirit. Again we appreciate all your work to stage these weekends.  SEE YOU IN MAY.

A Key Component of Effective Residential Treatment


Over the years, we have worked with over a thousand different families at varying stages in the treatment process.   When you work with that many families, you can’t help but observe some important recurring themes.

Statistically, almost 80% (77.5% in 2013) of our students in our treatment centers either graduate or reach a clinical completion that allows them to successfully transition to a lower level of care–a remarkable statistic for this industry.   Even in the other cases, our outcome data generally shows measurable and significant progress.  And, to be fair, the reason for an early discharge in these other cases is usually financial–completely understandable given the high costs of treatment.    That said, all treatment programs, ours included, have some families who don’t complete the program and that don’t get the full measure of benefit available.  These are the ones that break your heart–and the ones who offer such a contrast to those heart warming graduations that are the reason we do this.

Based on my years of seeing these patterns, I have to say that one characteristic almost single handedly assures us of significant clinical improvement–working with an open family system.   To me, this means a family that recognizes that just as they are asking their son or daughter to change, they, too, must be open to change; that everyone in the family be open to looking at ways that they can do things a bit differently in order to have a different outcome.

I want to be careful to say that a family being willing to look at itself and being open to change doesn’t mean that the family is necessarily to blame for their child’s current situation.  In fact, we often say that all parents do the best that they know how to do at that point in time.   Were they perfect?  Of course not.  Did they make mistakes?  Sure–we all do.  I have six children of my own whom I’m sure can testify about how flawed a parent I can be at times!   But please understand that for the vast majority of adolescents in treatment , changing one part of the equation (your child) without changing the other (your family system) is NOT a recipe for long term success.   This is why I believe whole heartedly that the programs that create lasting changes in teens in crisis all do deep family systems work!   For the population we work with, this means excellent therapists doing at least weekly family therapy (usually via Skype or the telephone given the distances involved), parents that have homework and clinical assignments concurrent with that of their child, and parents that frequently come on campus with the other parents for workshops, support groups, etc.   Our CERTS programs go one step further and actively seek to educate parents on the many issues surrounding their child: sexuality, depression, self-harming, etc. as well as teaching parents the skills and tools they will need through special parenting seminars and webinars.

Some very powerful things happen when a family is not afraid to look at itself and is willing to learn and implement new skills:  (1) you send a powerful message to your son or daughter in treatment that you are in this together–that you are willing to learn, grow, and change just as you are asking them to do; (2) you will learn skills that you will need when your child returns home–without which, your chances of success diminish; (3) you will likely correct some things that did not help your child given their diagnosis or personality.  These changes will also be a key element for long term success.

Significantly, when families open up, their paradigms of what they are experiencing change is some profound ways: a child that is accustomed to being the family problem prior to treatment, often becomes the catalyst that causes a family system to heal and be well again!   Countless times at graduations I have heard parents express gratitude for the “gift” their daughter has given the family–all the byproduct of a family system that makes the choice to look openly at itself.

Parents, perhaps feeling a little guilty about placing their child in treatment, sometimes look to give their child a gift while they are in treatment so that they will know of their continued love.  Well, I have a suggestion for a gift for such a family: give your child the gift of you being open and willing to learn and grow!  I cannot count the number of times that I have seen a fragile daughter gain the strength to change from seeing a Dad or a Mom also being willing to change.   Conversely, parents need to be aware that sending the opposite message (“She’s the one who needs to change, not me!”) is a powerful de-motivator that can cause a child’s progress to stop.

My advice to parents currently looking for an adelscent treatment center is to choose a program that provides regular family therapy, education, and skills training.  Choose a program that asks a lot of you and that expects you to change along with your child.  In fact, I believe strongly you should insist on it.  Why?   Because our years of experience  suggest that not having these things could well undermine later the gains that your child makes while in treatment.

What if you child is already in treatment?  I challenge you to give him or her the gift of a parent and family that is open to looking at your issues too.   Let them know what you are working on and learning every week, knowing that the pride they feel from hearing that “even Mom and Dad are working on their stuff” will give them the strength they will need to tackle what’s next.  This one, simple decision might do more to ensure a happy and successful outcome than just about anything else I know.

How Did I Get to Be Me?

I believe the title of this blog is something that most of us wonder about from time to time.      What many of us fail to realize, though, is just how fundamental our “beliefs about self” are to everything we are and do in life.

Let me give you an example.  Upon seeing a bad grade in math on my report card when I was in 7th grade, my Mom declared, “You are bad at math–just like me!”   Coming from my Mom, I accepted her statement as fact–and proceeded to earn a series of bad math grades in a row as a result!

I teach a class in our programs called Personal Leadership, where I outline for our students a 6 step process that largely shapes our lives: (1) Event, (2) Belief, (3) Behavior, (4) Payoff, (5) Cost, and (6) Truth.    To illustrate how this process works, I am going to use a real-life example from a girl that graduated from one of our programs a few years ago.  As a caveat, please understand that while this is a true story, everything I share here is what transpired from this girl’s perspective.

While at a family reunion, our girl was swimming.  Her uncle passed by her, saw her in the swim suit, and blurted out, “You’re fat.” (Event).  She felt shame and interpreted his statement as “You aren’t good enough for me or this family.  You are ugly.  You don’t belong.”  Her belief about herself became, “I am fat and ugly and worthless.” (Belief).

This girl knew of other girls around her that had eating disorders, particularly withholding of food or anorexia.  She tried that out (Behavior) and it “worked” for her.  She lost weight, garnered some attention, and significantly, felt some control over her life.  Although she didn’t like hunger, she DID like what she got from this behavior more than she disliked not eating.  As she lost weight and got positive attention (Payoff) and a greater sense of control, the behavior reinforced itself.

It took her parents a while to catch on–to have their delight at their daughter losing some weight turn to fear as she went too far.   As she lost pounds she didn’t have, they turned to therapists and education to teach her about the dangers (Cost).   Her eating disorder continued to spiral out of control until she found herself in our treatment center.  It was here she came to understand the truth about herself: that she truly was amazing with many gifts and talents, that she was beautiful inside and out, and that she had so much to share with the world (Truth).  She also came to realize her uncle’s own issues, and how that played a role in his comment.

This simple example illustrates the process that every single one of us goes through endlessly.   In psychology we call this “learning.”  Behaviorists will tell you that from literally the moment we are born (and I believe even before then) we are learning and making distinctions.   Significantly, what we learn combines with our genetics and personality to shape who we ultimately end up becoming.

So why do I choose to blog about this?  Because if we can LEARN something, we can also UNLEARN it!  The implications of the above is that I can change IF I choose, that while I may not be able to change what has happened to me (e.g. sexual abuse, adoption, death or illness, divorce, etc.), I can choose to change my perspective or “frame” of the event.  I can learn to see the good that comes even out of bad.   I can see the gifts that come even from tragedy and abuse.   Equally important is the fact that I can also choose my behavior about a belief–I can learn new healthier ways to cope with the events in my life. In fact, the only 2 steps in the process above that we can’t change or that don’t change are the first and the last.  But we absolutely can choose what we decide about an event (2), the behavior that accompanies that decision (3), and the resulting payoff and cost!  This is the heart of all therapy, no matter the modality, and is a powerful message of hope to all that struggle.

My math problems?  While in college,  I returned home from living overseas for a year and had some extra time on my hands.  Feeling behind, I picked up a math text and began to study it.  What I “learned” is that I was actually quite good at math and that I enjoyed it!

What can you “learn” today?   And if you have a loved one in crisis, what can you help them “unlearn?”   Feel free to comment and add your own perspective to this topic of hope.

Life Isn’t Over (In fact, it just got jump started!)

Imagine a girl that cuts, starves, and hates herself, and that has tried–and is likely to try again–to kill herself.  That’s generally the girl that I work with, and I’ve got to say that I could describe her much differently: she’s brilliant, beautiful, creative, sensitive, and would do anything for those around her.  Her problem is simply that she can’t see it.  Where I see brilliance, she sees stupid.  Where I see beauty and worth, she see ugly and worthless.

I have three residential treatment centers: for those of you who don’t know what that is, think boarding school for girls ages 11-18 with LOTS of therapy.   We are where you go when, as a parent with the daughter I described above, you don’t know what to do anymore.  In most cases, there have been multiple hospitalizations, years of outpatient therapy, and a family system that is spiraling in the wrong direction rapidly while this girl’s behaviors are escalating.   We are always the last resort.

But if you could only see the end!  This past spring I went with some of these same girls to Venice and Rome.  Together we ate gelato in Piazza San Marco, cruised the canals of Venice, saw all of the awesome sites of Rome and the Vatican, and added a segway tour (see photo below) to boot!  How did we dare do this?  Because these girls were no longer doing (or thinking of doing) the things that got them into treatment only 8-12 months previously.   They were still the same person–but they had dealt with most of their demons, had come to forgive themselves and others, had learned a new “toolbox” of coping skills and strategies to help them in the hard times, and most of all, they had learned to love themselves.   These same parents who had been through so many broken promises and sleepless nights could now see that these girls lives weren’t over at all.  In fact, literally their true lives were just really beginning.  And symbolically, being in Europe was a statement of just how far they had come!

And that brings me to why I want to blog: I want parents to know that there is hope.  Not every girl needs residential treatment.  Not every family can afford it.  But there are things that every family can do.  And with a bit of persistence and intelligence–combined with the right help–the overwhelming majority of girls can and do get better!

I plan on using this blog to spotlight (usually anonymously for privacy reasons) some of these girls.  Some of the stories will be about girls in our programs, because those are obviously the ones that I am most familiar with.  But I want to share hope and success from wherever it comes.   If you have a story to share, please contact me.    Lets spread the word–there is hope!!Image