As we work together to create additional meaningful ways of collaborating among all independent educational consultants (IECs), we are strengthening our commitment to help young people thrive.
The proliferation of mental health issues among young people continues to be very disturbing. Evidence of struggling, suffering, or just being stuck can be isolation, technology overuse, disordered eating, substance abuse, failure to attend school, failure to complete work, lack of participation in formerly enjoyed activities, choosing to have lower-achieving friends, defined anxiety and depression, experience of a trauma, and even suicidal ideation.
Nevertheless, there are effective approaches that enable young people to achieve positive mental health—a sense of well-being, satisfying social and family relationships, and the ability to pursue meaningful, productive activity.
In the interest of exploring opportunities to collaborate, I will explain some of the types of programs and therapeutic approaches that have been successful. The approaches to which I am referring are basically experiential: people live the therapy rather than “go to it.” Therapeutic support, while people are pursuing their lives, has been demonstrated to be extremely powerful.
Introduction
The following are questions to which therapeutic consultants regularly respond:
- How do you know if a young person needs extra support?
- What kinds of extra support are available?
- Are there a variety of levels of intensity of approaches?
- Do hesitant or unwilling young people end up hating their parents?
- How do you decide on the level of support?
- Do they have to leave their school to get and benefit from extra support? How do you decide to take that course of action?
If a college or school consultant is working with a client for whom some of these questions arise, therapeutic consultants are available to discuss possible approaches.
The therapeutic processes to which most IECA consultants refer employ experiential therapies—through which people “live the therapy,” i.e., they don’t simply go to therapy sessions, whether group or individual, but instead, they are supported therapeutically while pursuing life activities.
Some of the types of programs available are outlined below. Some are geared to participants with one type of issue—such as neurodiversity, technology addiction, or substance abuse—while others are heterogenous.
Programs typically focus on helping people define their values, explore their interests, find purpose and a path, and develop passions. All programs involve family work; participants are not sent off to be “fixed,” but are viewed as part of a system. Most programs are holistic in their approaches and look at nutrition, physical activity, executive functioning, and developing positive social relationships in the context of helping people to grow. Within each modality, there are specific programs focusing on substance abuse. Substance abuse for adolescents, and even young adults, is often a maladaptive coping skill rather than a full-blown addiction—and either can be treated. Overuse or addiction to technology is similar. There are a variety of approaches for helping students use technology in appropriate, balanced ways.
Therapeutic Wilderness Programs
Therapeutic wilderness programs serve children, adolescents, and young adults who are struggling, suffering, or stuck in any way. Participants live outdoors in breathtaking settings away from urban and suburban culture for approximately 30-90 days. Wilderness therapy offers a life-changing opportunity for participants to develop self-efficacy, accountability, motivation, and openness to new possibilities, enabling participants to embrace their strengths and deal with their challenges. Programs help people to find their strengths again, and to become resilient and eventually to thrive. Often a student who is having a hard time but getting through a year could benefit immensely from a summer or semester wilderness experience.
In some programs, participants live outside the entire time, while others are partially indoors, for perhaps half the week; some wilderness programs include academics. They all help people develop self-efficacy, so they both become accountable for their past actions and motivated to grow and change. Participants have 24 hours a day of experiential therapy in which they can establish new patterns. They develop positive coping skills for challenging situations, a sense of well-being, the ability to create satisfying social connections, and an understanding of how they can become productive in ways that are meaningful to them.
This sounds almost magical—and it comes about as a result of a multiplicity of circumstances. Dynamic therapy is provided with therapists coming into the wilderness for two or more days each week and experienced, highly trained and skilled staff carrying out the therapeutic work for the remainder of the days. Everyone carries their own food and sleeping paraphernalia, they learn primitive skills, they cook, they hike, and some programs include adventures like rock climbing or canyoneering. Living in nature, with a community of peers who arrive at different times and have a culture of working to be in a better place, is motivating and educational. The opportunity to work closely with others through a variety of situations and with therapeutic support leads to the development of a strong community. The break that participants experience from the familiar, including emotional triggers and technology, actually fosters neuroplasticity, which enhances the ability to grow and change. Wilderness programs are an extremely effective step in helping clients to find their strengths and become ready to address the issues they truly need to face in order to establish a sense of well-being. Such programs may be the first, intensive step for many clients, or they may be enough to allow someone to return to their life at home or in school and address the issues they have faced.
Combination Residential Treatment and Wilderness Therapy
Combination residential treatment and wilderness therapy involves participants living in a residential setting (a home or dormitory-like building) for several days and pursuing adventures in wilderness for two or three days per week.
Residential Treatment Centers and Therapeutic Schools
Residential treatment centers and therapeutic schools are geared to helping children and adolescents learn age-appropriate life skills with intensive therapeutic support. Participants may follow a short-term, intensive program only or pursue this as a step in their therapeutic journey. These programs include some form of academics which sometimes may be experiential and teacher-led and other times online. They also include intensive clinical support, with therapists often spending time in the milieu with students as well as highly trained clinical residential staff who help the students integrate the therapeutic teachings and insights into their lives. They use a variety of experiences, typically including recreational therapy to help students develop competence and to improve their mental health issues. They often work with students to improve executive functioning skills and address other challenges.
Young Adult Transitional Living Programs
Young adult transitional living programs support people ages 18-30 (with some variations, i.e., 17-year-olds and people over 30). They provide support for participants so they can learn and establish life skills, find success in school and work, and develop community. In some programs, people live in a group house, while in others they live in apartments alone or with roommates, sometimes in a complex all together, and others more separated. Some programs have externally structured limits on technology use, freedom to go out, etc. and others do not and use a relational approach to structure instead.
The programs offer a variety of community activities which can include cooking and eating together regularly, adventure, community service, cultural outings, etc. They provide different levels of therapy; at some, clients select their own therapists from the community or from within the program. In others, they are assigned therapists—and still others do not require therapy for everyone. Some programs are heterogeneous, while others are focused on people with neurodiversity.
Transitional programs provide multipronged approaches, including life skills and opportunities to be part of the community whether through volunteering, working, or school (or all three). This promotes participants establishing and living according to their values, exploring and defining their interests, finding purpose and a path, and developing passions along with positive social relationships and effectiveness at being productive. All such programs provide support as they encourage young adults to become successful at living independently.
Substance abuse oriented programs employ different approaches, like AA’s 12-Step program, SMART Recovery, or the Seven Challenges program along with broader therapeutic programming.
Technology abuse or addiction and disordered eating programs also exist and use similar approaches to the other programs.
Coaching and Mentoring Services
Coaching and mentoring services are proliferating for both after programs and before, or even as an alternative to programs. These may be provided by qualified therapists or highly skilled and trained clinically oriented professionals who provide mentoring and coaching services either in person or remotely. Having mentors come into the client’s life may be effective in determining whether someone needs more intensive support, as well as in preventing the need for greater support. In addition, parent coaching is provided by many experienced therapists and can be instrumental in helping families develop supportive, positive environments. Both types of coaching can supplement outpatient therapy.
By Cynthia Cohen, MSPH, IECA (CO)