The Anatomy of a Therapeutic Milieu…
We are absolutely thrilled when Sam announces that he had scored his very first basket in a competitive basketball game, a sport he previously had avoided like the plague.
Mark expresses pride in the fact that he has earned academic honor roll for two quarters and had read 3 books from cover to cover, contrasting his academic failure at the last school.
Bobby, just back from a weekend at home reports that he still had some arguments with his parents but “they” seemed to get along with him better. He even offered to do the dishes after dinner.
Of course, the above snippets (which are endless) make the Valley View community feel good. However, the “real payoff” of this work involves the necessary struggle with the young, feisty, authority testing, manipulative yet potentially highly engaging adolecent boy and may not come to fruition for many years. This was dramatically illustrated during a recent Parents’ Weekend when three students who were with us 18 years ago returned to share their experiences with the Valley View community. While all three had “turned out well” (a lawyer, MSW Social Worker and Computer Software Designer), the audience was riveted to their comments, at times were close to tears as the “boys” reflected upon the impact certain staff members (many still here) and various experiences had upon their lives. They talked about how the experience of feeling success and being cared for and understood had left an indelible mark of resilience, allowing them to succeed even with subsequent frustrations. Later, as staff reminisced, it generated the feeling (without being clichéd) that it is reassuring to know that although all of us are going to eventually have to leave this world, we will do so with the feeling that we might have done some good.
There is absolutely no magic to the ingredients of a therapeutic milieu or environment. One must start with the commitment to create a setting that provides boys with nurturance, definite structure, support and activities that stimulate youngsters both intellectually, emotionally and physically. While it would be irrational to imagine that one could or should create a “Pleasure Garden” or Disneyland, ingredients such as good food, smiling, communicating and having fun with their peers along with constant compassionate support from adults all play a vital role in the healing process. Certain skills, such as learning how to complete a task, evaluate where they stand relative to peers, and the ability to develop empathy and give of themselves to others are of significant developmental importance to growing boys. Other factors-community service, a rating system which provides weekly adult feedback of how they are performing and a financial system where boys are expected to earn their own spending money are all components woven into the fabric of a therapeutic environment. We are wary of “gimmicks” or allegorical stages of growth that are not necessarily accepted or translated by the young adolescent as a representation of the internalization of new tools or strategies in dealing with life more successfully.
From a standpoint of human development, we see many youngsters who, for a variety of reasons, are “stuck in a rut”, almost as if they had missed out on certain elements or experiences of childhood. Others appear as if they have “run into a stone wall” at a certain stage in their development. In other words, they may have performed more satisfactorily in an earlier stage, but with the intrusion of early adolescence and the academic and social challenges that accompany it, they seem to have given up. These boys often come across as frustrated, angry and depressed.
Early adolescence is the ideal time to approach a window of therapeutic opportunity. This demands a multilevel approach which in simple terms means creating an environment where boys are allowed and encouraged to be boys. Through providing a variety of experiences, opportunities through pragmatic psychotherapy (even though of limited impact in the past) as well as the assistance of medication where appropriately indicated, together, can steer youngsters towards increased self-understanding and putting their lives into perspective.
To identify what needs to be accomplished with a boy is a relatively simple task. Teaching youngsters to recognize, learn and use the tools and skills that go into making this happen is far more complex. There must be a staff of individuals with a history of experience, proper clinical training, and a well designed contemporary environment which can be assimilated by the young adolescent. The responsibility of an alert and well trained staff is to give boys constant honest feedback regarding their interaction with both peers and adults (family members included). From this, a connection should be made between such feedback and the underlying psychological issues that have led them to become “stuck” at a particular stage of their development. For boys of this age, a residential environment provides excellent unlimited opportunities to identify and hopefully learn to deal with these issues whether they occur on the athletic field, dinner table, class room or even on a shopping trip.
This process of constructing and maintaining a therapeutic milieu is far from continuous perfection and certainly does not happen overnight. Valley View School has been working with young adolescent boys for more than 40 years, and the majority of our present staff has been here for an average of at least eighteen of these. It is our mission to continue to do our best to “make the son shine” for the next one hundred years.