From the  Guest Editor

Coming Home:
What's Working in Transitions from Restrictive Settings

Lewis Polsgrove

Most parents and professionals working with youth with emotional or behavioral disorders have experienced the joy of witnessing a youngster make tremendous advances in his or her personal development. But jubilation can quickly turn to despair when successes lapse into the same behavioral patterns that required intervention. Often such "treatment" failures lead to blame-laying. Professionals tag parents as the "cause" of the youngster's problems; parents see professionals as ineffectual; the youth may become discouraged and ebb into hopelessness. When such breakdowns occur, everyone loses.

Professionals and families alike need to have confidence that the service approaches they select for their young people will produce significant and lasting positive outcomes. But just how much faith can we place in traditional intervention approaches? Not much, as it turns out. For example, studies have consistently shown that standard psychotherapy is no more effective than none at all (Levitt, 1971; Weisz, Weiss, & Donenberg, 1992). Although children and youth continue to be placed in residential facilities at an alarming rate, hospitalization (at an average cost of $500 a day) has proven expensive (Burns & Freidman, 1990), largely ineffective, and perhaps even detrimental as a service option (Sondheimer, Schoenwald, & Rowland, 1994). Various types of juvenile prevention and rehabilitation programs have also largely failed to produce permanent changes in behavior(Kazdin, 1987; Mulvey, Arthur, 1998 & Reppucci, 1993). Behavioral interventions, which have proven highly effective in producing immediate short-term changes, often fail to generalize across environments or over time (Baer, Wolf, & Risley, 1987). And although social skills training is a popular response to children's difficulties, recent reviews cast considerable doubt on its effectiveness (Kavale, Mathur, Forness, Rutherford, & Quinn, 1997).

Such consistently disappointing results can lead parents and professionals to the impression that "nothing works." But such a conclusion is far from the truth. We have all used strategies that do work with individual youngsters, and the professional literature abounds with descriptions of effective techniques and programs. However, we have not discovered a single "magic bullet" that will produce lasting and significant positive changes with all troubled or difficult youth in all settings under all conditions. These children and their families face complex and chronic difficulties. Like biomedical approaches to containing catastrophic diseases, we seem to be realizing that a combination of strategies over a long time span is the most effective approach (Borduin et al., 1995).

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This issue of Reaching Today's Youth extends the quest for promising solutions to assisting youth who have emotional or behavioral challenges as they transition from restrictive placements, such as hospitals, residential schools, and correctional facilities, back to natural, community settings. For this task, we have assembled a variety of writers-researchers, practitioners, and parents - to share approaches they have used to facilitate successful transitions. This collection of articles offers a spectrum of practices that range from techniques for individual youngsters to multi-strategy approaches that can be implemented in the larger community.

We have grouped articles for this issue into three categories: innovative school-based strategies to facilitate transition, techniques to aid families and individual youth in transition, and promising community-based approaches. In the first category:

• Eileen Yellin, Mary Quinn, and Catherine Hoffman share the voices of four youth in transition to illustrate how successful transition outcomes are often difficult to predict when commonly identified "protective factors" are used as the only guide.
• Lori Ernsperger describes how, as a consultant, she trained a paraeducator to provide a successful in-school program of support for a youngster with severe oppositional behavior who had recently returned to public high school after a year of residential placement.
• Mary McNeil offers a unique solution to the challenges of transition by pairing youngsters who have various types of disabilities with trained peer mentors who provide them with needed support in academic, social, and advocacy arenas.
• Mark Kennedy describes how the game of chess can facilitate eight positive transitions for young people, Teresa Skramstad reveals how transitions are facilitated when youngsters can connect with at least one academic activity in school - the process of writing.

In relation to practices that facilitate the transition process for families and youth:

• JoAnne Malloy and her colleagues show how they have used a personal futures planning process and the McGill Action Planning System (MAPS) format to base transition planning on a youngster's interpretation of his or her history, strengths, fears, and goals.
• Patricia Harmon shares the story of her son's own experiences with transition, presenting a parent's view on what does and does not work in the transition process.
• Karen Barnes, Hope Currin, and Mary Ann Gray provide five concrete recommendations on how to make navigating the labyrinth of transition services a little easier for parents and educators alike.
• Sharon Field and Alan Hoffman describe the crucial role of self-determination for youth in ensuring successful transitions.
• Finally, Sherry Kolbe describes how parents and educators can use the tools of advocacy to ensure the most effective and legally appropriate services for youth with special needs under the new IDEA Amendments of 1997.

In the promising community-based approaches category:

• Nicole Deschênes and Hewitt Clark report on a study they have recently completed that identified seven components of effective transition programs across the country through a survey of 254 such programs and site visits to 9 of them.
• John Burchard, who developed wraparound services in Vermont, shares his views on three major shortcomings of traditional, categorical services and presents the case for the individualized services that wraparound provides, based on the needs of youths and their families.
• Tamara Brown and Scott Henggeler describe the "multisystemic" therapy (MST) treatment that has produced impressive and long-term successes with a wide range of children with emotional and behavioral disorders.
• Lyndal Bullock and Ann Fitzsimons-Lovett continue their series of professional development workshop outlines in a session on teaching youth to manage their anger.
• Finally, Michael Bullis and Michael Bent describe three crucial components of the effective community-based transition programs they have developed and studied.

With varying degrees of rigor, each of these approaches has been field-tested and demonstrated to be effective. We hope readers find in this rare cross section of perspectives on facilitating the transition of youth with emotional or behavioral disorders not only new strategies, but cause for renewed faith that "some things do work."