Every research study we have seen on characteristics of programs that are effective establishes that the formation of quality relationships is the most critical factor in therapeutic change.  When studies show that differing therapeutic styles and methods do not result in significantly different outcomes, the kind of relationship between the therapist and the client (in outpatient situations) and between the student / client and the staff they have the greatest contact with (in residential situations).  

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Our first concern is that the relationships between students / clients and staff people of the school / program are recognized as the most important ingredient in healing of pathology and positive behavioral change.   Schools and programs with particular philosophical commitments need to remember that regardless of the value of those philosophical commitments – which might be considerable – the fact that fostering these relationships are more important.  

Most programs would at the very least pay lip service to agreement with that, even if they don’t all fully support that in practice. But with the rarest of exceptions, therapists and other clinicians are not the people with the most potential to form such relationships, a fact that more schools and programs might challenge. One exception to the subordinate role in relationships might be New Summit Academy where fully qualified therapists personally take on some of the duties that might be assigned to "child care workers" or "techs" or "houseparents" in many schools or programs. This is the kind of exception that proves the rule.  The relationships that will be most pivotal in determining success are the frontline workers who are with the clients.

Ray Curtis at Forest Heights Lodge has stated that the ONLY role of a therapist in a residential setting is to facilitate the effectiveness of the front line workers. I might not express it that way, but we need to pay serious attention to the question of whether or not the front line folks are capable of developing quality, healing relationships.  Actually, we think therapists do have some duties besides facilitating the effectiveness of the frontline staff.  However, we do not think therapists in residential settings (or outpatient therapists in the community) can be effective instruments of change if the total environment in which the young people live does not support change and include high quality relationships with people they interact with on a day-to-day basis. When touring a facility to evaluate its appropriateness, arrange to meet some of the front-liners. You want to see the kinds of people in those positions that you would want to see developing close relationships with a child or young adult. You want to know that the institution embraces the fact that these people will develop the primary relationships with the students/clients, that they are the primary agents of change, and that they are properly guided and directed to maximize their effectiveness in that way.

Feedback is invited. We will  publish selected feedback.  Email FamilyLightResponse@yahoo.com

Disclaimer: No  program review, no matter how positive, is a blanket endorsement. No criticism is a blanket condemnation.  When we express our level of confidence in a school or program, that is our subjective opinion with which others might reasonably disagree.  When we assert something as fact, we have done our best to be accurate, but we cannot guarantee that all of our information is accurate and up to date. When we address compliance with our guidelines, you need to remember that these are only OUR guidelines -- not guidelines from an official source.  We have also set the bar very high, and do not expect any school or program to be in total compliance.  It is not appropriate to draw a conclusion of impropriety (or even failure to live up to conventional wisdom) from our lack of confidence in a school or program or from less than perfect conformity to our guidelines.  Some will say we expect too much. Readers are responsible for verifying accuracy of information supplied here prior to acting upon it. We are not responsible for inaccuracies.

Last revised 09-14-08; Menu adjustments 10-07-08