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Transitions into residential placements?

2009

Hi all,
I have a question about differing practices around the world in relation to transitions into placements. Does anyone know of any research or literature about the optimum length of time for a good transition into a placement, and what kind of activities or procedures are followed in relation to transitions?  Also, could anyone speak to their own service's practice in relation to this issue?
 
Australia is just beginning to introduce therapeutic residential care and we are looking for ideas in some areas such as this.
 
Cheers
Laurel Downey
Cairns, Australia
...

Laurel,
 
Transitioning into any facility is difficult, especially for youth who are going into residential care. Depending on your age group will depend on what you are able to offer them and what steps you need to do to work with them to make the transition run as smoothly as it can. It is also important that you prepare the youth for the transition so that they are aware of what is going on and what is going to come of it. No matter what they need more support at this time then any. They are going some place new and chances of them knowing people could be slim, especially staff. I know that when I worked with youth getting ready to transition into a new facility we sat down and had an open conversation about it, let them know where they were going, what to expect and what they wanted to work on before leaving the current facility. The youth have a voice and it is important they are listened to. That at times is our biggest mistake. For our older youth at this one facility we started it as soon as we found out the transition was coming. We didn't share all the information at that time as the location wasn't known. The first step we took was talking about goals! A transition can take a few days, weeks, months. It all depends on the time frame that management and community services gives you. Making sure management informing the staff of what is happening in the meetings is also key so that you can help the youth the best way that you can.
 
Ashley Gibbs
...
 
Hi Laurel
 
Don't know of any literature.
 
Some things I've learned over the years.
 
1.  For the parents.  A man with whom I worked in the 1980's used to take time to make two special points with parents:  Your child will be safe, call whenever you need to.  Do not feel guilty.  You worked hard and struggled. You deserve a break.  Trust us to care for your child and relax.  Treat yourselves to something special.
 
2.  It was fairly traditional in most programs in Louisiana to have a 30-day adjustment period during which time children were not allowed home passes. This was generally accepted as common wisdom and was common practice.  Then, in a group home that closed on holiday weekends and sent all the kids home, we had to send home children on occasion on their first or second weekend in the program.  It didn't seem to compromise their transition into the program in any way.
 
3.  I prefer to admit children early in the week.  I do not take kids on Thursdays if I can avoid it, and never on Fridays.  In reviewing some data, I noted a high correlation between children who failed in the program and the time of the week they were admitted.  Successful kids were admitted early in the week, those who failed tended to have been admitted on Thursdays or Fridays.  In fact, all of the children who were admitted on a Friday failed in the program within 1 to 3 weeks, for various reasons, including being 'rescued' by parents who removed them from the program.  I theorized that relationships are important.  Not just with staff but also with other children.  During the preadmission screening and the actual admission, children tend to develop relationships with the 'professional' staff - social workers, managers, administrators - the people who tend not to be available on weekends.  And weekends tend to be more relaxed and less structured.  So new children feel abandoned when all of a sudden they are left alone for 2 or 3 days with both kids and staff whom they do not know, and don't see the people they do know for 2 or 3 days.  They are vulnerable to any kids who might take advantage of them, or who might seek to develop relationships with them that are counterproductive, as when kids who are not doing well in the program look for allies or support from new kids who have not yet formed other relationships.  When children are admitted earlier in the week and have a problem on their first or second night, they can find staff the next day with whom they have begun a relationship.  I am sure skillful and well trained weekend staff can minimize or avoid s
uch problems, but I prefer to avoid the problems. 
 
4.  I do not admit more than one child on a unit in a given week.  New children feel vulnerable.  When two new children are admitted in the same week, this is a strong bond - the two new kids tend to form a very strong relationship that sometimes undermines their developing relationships with staff and with other children.  They tend to support each other.  When one of them has some tendencies to be oppositional (most of the children we treated tended to be oppositional) and has the support of a peer, this can be a very challenging obstacle to overcome.  When only one child is admitted in a week, new children are more likely to form healthy relationships with staff and be open to more healthy relationships with other children. 
 
I don't know whether others will agree, but that's been my experience. 
 
John Stein
New Orleans
...

Concerning transitions into residential placement, I failed to mention in my previous reply about setting expectations with children before they arrive. 
 
I learned from hiring staff that whatever we talked about in their job interviews were the job they accepted - the job they came to do.  If we talked about activities and counseling, they came to do activities and counseling with the kids.  They made these things priorities did these things well.  But then it was very difficult to get them to do other things, like make log entries and write reports and supervise chores.  When we talked too much about reports and log entries, they made these things priorities and did them well, but spent too much time in the office and not enough with the kids. So we began to be very deliberate in setting expectations in job interviews.
 
It's the same with the kids. In our pre-placement interviews, we used to tell kids about the good stuff - the activities and the recreation - in addition to the treatment stuff.  Then realized some of the kids were coming expecting only to have fun and play games. We stopped talking about the fun stuff and concentrated on the other stuff, responsibilities, school, study hall, expectations, etc.  We let the fun stuff take care of itself.
 
And we used to do interviews with the kids and then admit them the same day.  We came to realize that the expectations with which they came to the interview were often not realistic.  State workers were not always accurate in telling children what to expect, and children did not have time to digest what we told them in their visit if we accepted them the same day.  So we adopted a policy of not admitting children immediately, scheduling admissions at least one day after the interview so that children would have some time to adjust their expectations.  And we had children visit the program for a few hours during the evening routine of dinner, cleanup, study hall, and chores. It helped a lot with their initial adjustment to the program after they were admitted.
 
John Stein
New Orleans
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