I am sorry to hear about the very hard time you and your grandson are having. Of course you are afraid! Who wouldn't be when their beloved child has been court-ordered into this type of facility and you have lost so much control.

Your best bet is to develop a good working relationship with your grandson's probation officer. Ultimately, the probation officer has responsibility for monitoring your grandson's treatment and progress as well as ensuring that the facility is performing its obligations adequately and without violating state standards. The probation officer will still be in place as personnel at the treatment center come and go or if your child is moved to another facility.

Do your best to work in a business-like way with the probation officer, and generally speaking, keep your emotions in check and your tears and handwringing at home. Keep in touch even if you don't like him/her, and try to organize your concerns in a way that is respectful of his/her time. The probation officer's job is not to care about you & how you feel, so keep the focus on your grandson's medical treatment, therapy needs, education, care, supervision, safety, etc. By all means, advocate for your grandson's needs.

Things you may want to find out about: How are children and placements matched up? Why was this placement determined to be suitable? Did you get any kind of parent handbook from the facility that describes their philosophy, practices, rules, parent/family role, etc.? What are the legal rights of children in this facility? How does the facility measure success? How long do they think it will take for a successful outcome? This type of facility is required to file Incident Reports of any assaults, injuries, restraints, and serious violations of rules (legal or illegal); your probation officer should have these records and you may be entitled to them as well (depends on what rights the court or state laws allows you). I would want to know how many Incident Reports this facility typically has and how that compares to other similar facilities. I'm not trying to scare you, but it's better to have your eyes open so that you can begin to evaluate the appropriateness of this facility for your grandson.

I would start an electronic or handwritten journal/logbook and record dates and conversations with your grandson (by phone or in person) and/or care providers -- in particular you might want to keep track of things that your grandson complains about or things that disturb you about his interactions with staff or other kids. You can include good things too, but it's can be valuable to keep track of the unpleasant things too. Several months from now you may realize that something "funny" is going on and that it's been going on for a while. Or you'll get new information that will shed new light on past incidents and you'll be able to review them if need be. Having a journal with dates & notes may help you build a case with the probation officer to have things changed.

It will take several months before you will be able to see if there are signs of progress or decline in this facility. The more you pay attention to what's going on, what works and what doesn't, the better positioned you'll be to gain and keep the probation officer's ear.

Daunna Minnich
Moderator, JBRF Education Forum

Check out this NAMI booklet designed to help families understand the value of evidence-based practices for mental health treatment of children and youth:

http://www.nami.org/Template.cfm?Section=child_and_teen_support&template=/ContentManagement/ContentDisplay.cfm&ContentID=47656

The booklet includes a long list of questions that you might want to put to the probation officer and to the people who are running your grandson's treatment center. You'll need to approach them all in a non-aggressive, "please educate me" manner, along the lines of "I found this resource describing evidence-based practices and I'm wondering how you have gone about developing your treatment program to make use of evidence-based practices" rather than "Do you use EBP? Prove it! And if not, why not?"

Most residential programs rely on some form of Behavior Therapy, which is described in the above booklet as a system involving rewards and consequences (or you may be more familiar with the notion of carrot & stick). This booklet will tell you that Behavior Therapy can be effective for kids with ADHD or Oppositional Defiance Disorder, which often accompany bipolar disorder. If your grandson happens to have one of these labels, that doesn't automatically mean Behavior Therapy will be effective; just as teachers will tell you that students must be "available for learning" (fed, adequate sleep, no tooth aches, has background knowledge or skills for the task, etc.), so too must a child with bipolar illness be "available to respond" to Behavior Therapy — in other words, medically stable (not psychotic or explosive at the drop of a pin) and able to think, reason, and articulate his concerns and feelings to some extent.

Behavior Therapy also comes in different flavors, but they all are all based on the idea that if a child is motivated enough, he will comply with rules and expectations. The often-forgotten underpinning to this theory is that a child must have the ability to understand or "read" the social situation accurately. Behavior Therapy is doomed to failure if the child cannot read the social situation that triggers ODD or explosive behavior. The work of Ross Greene ("The Explosive Child") details the hidden cause of some behavioral challenges that will not respond to traditional behavior management — in cases where the problem is not the child "will not" but that the child "cannot" do what is expected. Here's a website with some of his ideas that are being studied and found to meet the evidence based practices standard :

http://thinkkids.org/approach/approach.aspx

You won't convert your grandson's treatment center to new approaches, but if the program is not working for him, you'll need to get the probation officer to evaluate the reasons for lack of success in order to select another program more likely to bring success.

That said, maybe the program your grandson is assigned to will work reasonably well for him — and that would be a great outcome.

Daunna Minnich
Moderator, JBRF Education Forum