Intensive day treatment provides an alternative to residential care - Phoenix program in Moline, Illinois, for high-risk teens

Children Today, Sept-Oct, 1989 by John Hamm

Intensive Day Treatment Provides An Alternative to Residential Care

Timothy Carlton's life was out of control. Grades were hitting basement levels. So was his demeanor. Friends left. His parents couldn't reach him. As Timothy withdrew into a private world, he grew to believe that he possessed the powers of comic book heroes. Sometimes he'd dash in front of speeding cars to test this newfound strength. Once he sat on a roof with a noose around his neck - trusting in super powers for protection. By age 12, the real world had evaporated into a barely perceptible mist.

"The hardest thing was putting our son in Zeller for a year," Timothy's father remembered. "And after that, we had doubts about any program."

Difficult choices confronted the Carlton family after 13-year-old Timothy was released from the Zeller Mental Health Center in Peoria, Illinois. Timothy's lengthy institutionalization for depression and selfdestructive behavior had already left the family emotionally drained. Regular school was out of the question. Home life without outside help was doubtful. Few alternatives seemed available outside of another institution. Then they heard about the Phoenix program - a day treatment center in Moline, Illinois, that provides intensive educational, social and mental health services to high-risk teens.

Phoenix serves youths only a step away from placement into correctional or mental health facilities. With a diversity of services under one roof, Phoenix offers severly emotionally and behaviorally disturbed youth the intensity of a residential treatment program without the need for overnight stays. Families are kept together. Students attend classes and activities from 8:00 a.m. until 9:00 p.m. Each family receives regular counseling support; social workers are on 24-hour crisis call; and short-term respite residential care is available to give both families and students a break.

Timothy was a typical candidate for the Phoenix program. By the time the intake committee reviewed his placement request in 1987, his case files already chronicled a long history of behavior problems. He had spent time in a residential facility and would likely face a repeat placement. His problems were too great for local schools, even regular special education programs, to handle. Yet success was possible in a highly structured day treatment program. The intake team approved his admission.

Timothy's first months at Phoenix were difficult. His compulsive lying held strong. Sometimes he would even accept blame for things others had done in hopes of gaining acceptance. Yet friends were still hard to come by, and his grades remained low. But eventually structure and liberal doses of positive reinforcement encouraged the troubled youth to risk changing his life. Teachers helped turn failing marks into passing marks, and then A's. Social workers taught basic communication skills and encouraged the building of new relationships. Coaches worked on Tim's motor skills so other kids won't be so likely to tease him when he returns to a regular school next fall.

"From D's and F's to A's - that was quite a shock for his mother and me," Ted Carlton recalled. "Yet it wasn't really something that happened overnight. It was like a big experiment, rather than a closed and shut case. We've had a struggle. But my wife and I stand behind the program one thousand percent."

The success in Timothy's life can be traced, in part, to the program's emphasis on positive reinforcement. Once during a dodge ball scrimmage, Timothy missed his target by several feet. "Good shot," yelled the coach. "That's the way to aim. That's the way to move that arm back there." During a volleyball game later that evening, Timothy took a minute to catch his breath. A worker went over, put a hand on his shoulder, and praised him for improved patience on the court. Later that night, after an art class, he was told that he had earned enough "points" for good behavior that week to win a pizza party.

"Some people think of this as just a latchkey program - as day care for troubled kids," said social worker Mary DeRue about the afternoon and evening therapeutic recreation programs. "But we're really practicing social skills and trying to develop relationships as well as give recreation. Things like conversations and introductions sound pretty basic, pretty elementary. But we're dealing with some pretty basic, pretty elementary needs. For some of our students, getting through a single night without an outburst is a big accomplishment.

"We rarely have winners or losers here. If a kid gets upset, he can take a time out. We can work with him in a small group or even one-to-one - whatever it takes to cut down on embarrassment and make him feel good about himself."

Positive reinforcement continues in the classroom: pats on the back, encouraging words. At the end of every class period, points are individually awarded for good behavior. A study hall of sorts is reserved for "time outs" when a student becomes disruptive. Points are added up at the end of the day, helping students to track their progress. Sufficient points earn "tickets," which can purchase school supplies and privileges, including the right to return to classes at a regular school.