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102 JULY 2007
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expanding the circle

One family’s adventures in transition

Patricia Harmon

My son starts work today. Yes, for the first time in about a year, my son is employed. He is 20, has a GED, and is optimistic about his future. Although he has been diagnosed with depression, currently he does not need to receive mental health services or take medications. But just two years ago, he was on probation, involved with gangs and drugs, taking numerous medications, had dropped out of school, and was unemployed. How did we get from there to here? It has been a series of adventures in transition.

My second pregnancy was physically healthy. My son's father joined the military a few months before I gave birth and returned to his duty station within a week of my son's birth. I was a married, single mother from the beginning, attending college and caring for a daughter from a prior relationship. My one month-old son was in the (unlicensed) care of a neighbor while I completed the semester. Who knew you needed standards of care? I structured my life around my children. I studied while they played or slept. We spent quality time together. I read to them, and they often went to school with me. We attended dance classes together, and I made friends who had children their ages.

Our journey started when my preschool-age son was diagnosed with developmental delays by a military physician. The physician did not explain what this meant, and we assumed we understood. We did not. After my son experienced chronic behavior difficulties while in preschool and kindergarten, we went to our community mental health department, where he was diagnosed with ADD. But Ritalin did not do much to improve his behavior. Eventually, after a fight with a substitute teacher in third grade, he remained out of school for 60 days while his special education placement was re-evaluated. A home school teacher visited twice a week – if his schedule permitted. I had to arrange for child care during this time, because I was employed.

My son's new label was Severely Emotionally Disturbed. I was hopeful that a combination of the school ruling and continued therapy would help his progress. But right away we ran into roadblocks. We had to change his school placement because the principal did not want him back. He was sent across town to a predominantly white school, where there was supposedly more structure.

Several years later, after two more elementary schools, one acute care facility, a residential health program, and a day treatment center, we had our first experience with “transition.” Although the day treatment program had carefully outlined a plan for his gradual return to public junior high school, the school did not follow it when the time came. My son had been out of regular schools for about three years at that point, and the culture shock was great upon his return. His teachers were not prepared to deal with him. He was not happy either about being in a self-contained EBD classroom, and the school district discontinued the individual and family therapy we had received at the day treatment center. We continued to see the therapist privately for a while, but it eventually became too expensive to continue.

Like many teenagers, my son began to withdraw from church and related activities. He became more rebellious, began a low key involvement with a gang, and spent about 10 weeks at a training school for theft. After a fight at school with a childhood playmate who was a member of a rival gang, the school and mental health staff decided he was antisocial and truly a danger to himself and others. He was once again removed from school.

Meanwhile, I was referred to a new group that was starting in the state-a local chapter of the Federation of Families for Children's Mental Health. I began to learn how to advocate for my son's transitions in earnest. I attended several national conferences and heard about new programs and initiatives in the field of mental health. For example, I heard Rusty Clark (Florida Mental Health Institute, University of South Florida) speak on transitional services, and I attended another national conference on wraparound where I received practical information on starting the transition process. When I returned to my home town, eager to begin working with the school, I was told that it was too early to start transition planning. (State law did not require it until age 16.) I contacted the State Department of Rehabilitation and reviewed their state plan, writing a formal request for lowering the age to 14.

I found out that a state developmental residential program employed a transition specialist, and he agreed to begin facilitating the process for my son. Our transition team consisted of myself, a music store/recording studio owner (since my son is an aspiring rapper), a vocational rehabilitation counselor (who claimed he “didn’t know what he could do to help"), my son's community mental health counselor (who believed my son was a “social deviant"), and various school officials (some of whom were supportive and others who were just doing their jobs).

Our first meeting was not a success. My son drew the whole time (I didn’t realize this was a coping mechanism). One “advocate” felt we should not invest a lot of time in planning because he was not paying any attention to the process. We never met again and my son grew more and more disillusioned with school, finally dropping out after a discipline meeting with administrators who proposed calling the police when he cut class.

At this time, I was in transition myself, taking a job with Mississippi Families as Allies that required me to move out of town. My son did not want to move with me, as his rap group had begun to perform and was about to produce their first recording. I told him he could stay if he could find a responsible adult to live with. I could not imagine anyone taking on this challenge! But I was dead wrong. Even after I gave a history of my son's past behavior, my son's producer wanted to take him in.

A year later, when this relationship went sour, my son was not permitted to return to high school and was unable to keep a job, so he came to live with me again. We had difficulty with our new arrangement. He went back to the producer, who eventually put him out. He slept where he could, sometimes on streets, and was eventually arrested for breaking and entering. After a year, he was found guilty and given probation and a fine. He was still homeless and unable to keep a job. When he returned to court, he admitted to smoking marijuana and was sentenced to a boot camp program, where he served for eleven months.

Which roads lead to successful transition?
Could these restrictive placements have been prevented? If our transition planning had included certain crucial elements, and if appropriate services had been available to my son, they probably could have been. Our own adventures in transition, as well as the experiences of friends and their children, have helped me identify a number of roads that can lead to successful transition.

Transition plans should be built on the self-identified strengths and aspirations of the young person. After attending my first conferences on wraparound, I was excited about the idea of transition planning that would build on my son's interests and include people who could raise his awareness of how these interests might be used in a career. Since my son had a natural talent for music and a strong interest in rap, I suggested that our transition team find a musician to work with him. Someone on the school district staff knew the owner of a local record store and recording studio who had been a professional musician. We invited him to our first meeting, and he accepted. But in the meeting, rather than encouraging my son to pursue his music, we were surprised to hear him say, “You need to concentrate on school. Music is an iffy business. Almost no one makes it.” Although this was true, it was not the reason we had sought his participation on the team. Looking back, we could have suggested to him that he give my son a job in his store in return for studio time, rather than wages, or that he donate studio time as a reward for good grades. But we failed to propose these positive alternatives and the opportunity was lost.

Another missed opportunity was my son's interest in art. He was an excellent self-taught artist, who had a real talent for cartooning, and was even encouraged by one art teacher to draw for a portfolio. Again, I could have related good behavior or school achievement to his participation in an art course. But by the time I had learned about an art center that provided such courses, he was so disillusioned by school that such a trade no longer held any promise.

Supportive family members and other significant adults should be involved in the transition planning process. When my son was in detention, he became involved with an artist who volunteered through a black fraternity’s mentor program. When my son's artistic talent came to this man's attention, he took him under his wing, giving my son art supplies, picking him up for activities, and talking with him when there was a problem, man to man. He even continued his contact with my son when the fraternity program was discontinued. Had transition planning been part of my son's detention, this man would undoubtedly have had a wonderful influence on the process. But too often, such important adults who are not the child's parent remain uninvited and uninvolved in supporting services for the child.

Professionals who provide advice and referrals must continue to assist even when the youth has not succeeded. One of my most frustrating experiences with services was my son's brief involvement with a drug rehabilitation program. When I began to suspect that my son was smoking marijuana and confronted him about it, he denied it. However, his drug related behavior eventually became so extreme that on one occasion, I actually called the police. I also called his probation officer, who convinced the police to bring my son into detention, where he tested positive for marijuana. He chose to go to a drug rehab program in lieu of going back to detention, freely admitting to his drug use. But when he actually arrived at the program, he denied that he had a problem. Since the program was 12-step, staff claimed that “because he won’t admit to it, there’s nothing we can do.” After only two weeks, they sent him home, claiming that he was “noncompliant.” It frustrated and angered me that a program designed to treat addictions would be stopped in its tracks by a resistant youth who had difficulty admitting his dependence. This experience was but one of many in which professionals refused services to my son because he did not succeed in meeting their goals for him.

Well-coordinated, comprehensive services that focus on young adults as well as youth in transition should be available. The limited spectrum and variable length of transition services for youth is an issue all across the country. Some states start transition planning at age 14, some at 16. While successful transition requires a wide variety of services, including ones that focus on education (e.g., GED), vocational and employment skills, housing assistance, life skills training, recreational activities, advocacy training, and drug rehabilitation, all of these types of services are not often provided. Even when they all exist, they are frequently uncoordinated.

Furthermore, many services that would clearly be helpful to young adults in transition are provided only to those with serious disabilities. For example, an assistive living program in our community for the developmentally disabled provides these individuals with their own apartments in a building staffed by case managers who supervise the site 24 hours a day. The managers help residents learn the skills needed for independent living, such as going shopping, making a grocery list, budgeting their money, and paying the rent. However, such positive services do not exist for youth like my son, who have normal levels of intelligence but emotional and behavioral challenges or mental illnesses that can make it very difficult for them to live independently.

Transition services should begin before the youth reaches 16. When my son turned 16, one transition meeting was held only after aggressive advocacy on my part. But that one meeting was it. Although some helpful career interest testing was done at that time, members of the transition planning team were far too easily convinced by my son's difficult behaviors at school that he just “didn’t care.” In response to his apparent apathy, his “advocates” could find no reason to “waste their time” on planning. Once again, I was surprised by the far more proactive services that were provided for developmentally delayed youth. These students were almost pushed to supported employment, while those like my son were left to their own devices.

Age-appropriate services should be available. Youth in transition often face a rude awakening when they reach their majority. At age 18, the only service that often remains available to them is vocational rehabilitation, and even this service varies greatly from state to state. Furthermore, young adults often fail to take advantage of adult services and scholarships for which they are eligible, since obtaining them requires admitting they are “disabled” or deficient in some way. In particular, youth who have been labeled during their school years (e.g., as EBD, SED, LD) often do not want to continue accepting such stigmas when they turn 18 and finally have a choice about it.

Often programs and services provided to young adults in transition have been designed for chronically mentally ill adults. For example, my friend's son is schizophrenic and he was sent to a clubhouse program for the adult mentally ill after he turned 18. In this program, adults would go to the local mental health center to be taught recreational skills. My friend's son participated in these activities with middle-aged and older adults, once even playing basketball with a 67-year-old woman!

Youth in transition need opportunities to meet and talk with others who are experiencing the same challenges. Young people will be drawn to peers in situations similar to theirs. This interaction can either reinforce negative behaviors or encourage positive ones. Such group support and talking to other kids “in the same boat” can be especially beneficial to youth in transition. For example, in my son's day treatment program, group sessions were held frequently during which the young people could discuss their most pressing issues. Often, they were more willing to admit to their problems when they were pointed out by peers.

Services need to be culturally appropriate. During my son's many transitions, we received counseling, both through the school and privately. Some of this counseling was helpful, and most of it was provided by women. However, my son's two male therapists provided a perfect example of how competence in cultural, socioeconomic, and racial issues can have a tremendous influence on the outcomes of counseling.

I chose one white male therapist at my son's school because I knew he was very talented and related well to young people. Things seemed to be going well until my son was in a fight with one of his peers (the incident described earlier). The counselor, who was not well informed about gang behavior or attitudes, viewed the fight as an example of antisocial, vicious behavior. In fact, my son had chosen to fight during school hours since he knew it was the only time that this rival gang member did not carry his gun. Without any awareness of these factors, the therapist was unable to work through the incident with my son in a productive way.

Later, we found an African-American psychiatrist who tapped into my son's cultural context right away. At our first appointment, this therapist entered his office to find my son sitting in a slumped, cool, “I don’t care” posture. He immediate addressed the posture in a calm, respectful way. He explained what the posture conveyed, and told him frankly that “people won’t deal with you if you present yourself that way.” While I’d been saying “Sit up! Sit up!” for years, this man got through to my son by talking about how he as an African-American male needed to present himself in order to gain respect, avoid provoking police, etc. He tied all these recommendations to my son's aspirations to be a rapper.

Our transition continues
Our rocky adventures in transition are not unique. Almost all youth with emotional and behavioral challenges face similar difficulties as they and their families struggle to advocate for transition services, take the best advantage of those that are provided, and compensate for those that are not. Hopefully, stories like ours and the lessons we have learned can help youth, families, and professionals alike arrive at happy endings to their adventures.

During my son's eleven-month stay at the boot camp program, we continued to correspond, and I accepted his collect phone calls. His attitude was affected by this truly restrictive and structured environment. He sent me hundreds of his raps, and he completed his GED with very high scores. After his release, he came to live with me once again. But our relationship is now mutually respectful. He has matured and is more willing to compromise than before. On my part, I realize that he is an adult with experiences that have strengthened him and made him more responsible. I am still looking for ways to assist him in his transition to independent adulthood, but I have learned to make suggestions instead of demands. We are finally becoming friends. And he has now found a job on his own. He starts today.

This feature: Harmon, P. (1998). One Family’s Adventures in Transition. Reaching Today’s Youth, 2(4), pp. 30-33

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