SPEAKER_00 0:00

Why is saying no to certain referrals one of the most important parts of your role?

SPEAKER_01 0:04

That's a good question. It's one of the hardest parts of the role. But one of the things that we want to look at and make sure of is that we have the capacity and we're able to help them. And so if they're not a fit and they need something different than what we've got, then it's better for them to be able to go to that spot and get those the support that they actually need. So making sure that we're not just taking anybody because we want to help anybody we can, but making sure that we find the right ones that that need what we can provide is really important.

SPEAKER_00 0:34

All right. Awesome. Question two. What's a hard truth you share early with families that actually build long-term trust?

SPEAKER_01 0:41

One of the things that we start with right from the very beginning is making sure that they really understand what it's like and how treatment can be difficult and it can be fun and rewarding. But sometimes the hardest part for them is the amount of time that it's going to take. Usually the average that we see is about 12 to 14 months, just kind of depending on the individual. And so looking at that timeline, it can be scary and hard at times, but making sure that they understand that it really takes time. If you try to do something, especially with the intensity that we deal with, if you try to do that fast, it's not really going to work. In order to provide lasting change, there's a time element to that. And so helping them understand that, and it's not going to be a quick fix, it can actually build some of that trust. We're not trying to tell them it's going to go by real fast and be a quick fix, but we want them to be able to understand that it's going to take some time.

SPEAKER_00 1:39

That's sweet. All right. Question number three. How does Havenwood's pre-admission process prevent harm before treatment even begins?

SPEAKER_01 1:47

One of the things that we love doing is we actually do an interview with every single one. We'll initially hear from the family and the parents, and maybe a referral source, a school district, another provider that's already working with the family. And we'll review documentation, we'll do an application from the family, look at kind of the clinical history and background. And then if we feel like it's going to be a good possibility, we'll get on a video call with a number of people here on the team and with the potential guests with the individual and with their family, and just talk about what it's like here at Havenwood. We want to get to know them on a different level than just paperwork. Paperwork doesn't always give the best picture. We want to start by getting to know them individually and what they're really like and how they interact with people around them, peers, staff they've been with, teachers, and their parents. And we actually find quite a few things out through that interview that we didn't have on the paperwork. And so it's pretty interesting to see there. And the way that that helps is they know what's happening. They're involved in the process from the beginning. And so starts off with a better experience, just getting to see us and get to know who they're going to be working with.

SPEAKER_00 3:00

Right. That's awesome. So what makes a student a good fit here beyond diagnosis and paperwork?

SPEAKER_01 3:07

So a lot of times there's histories of aggression, and most of that is coming from trauma. Some of the other discussion we've had is the interview that we do, we can figure out where their functioning level is in relationships. So they don't have to be good at relationships necessarily, but we want them to have a desire to be able to heal from relationships. And so that's really the main thing that we're looking at. A lot of times in other treatments or other situations, they get aggressive and they're reacting to a trauma trigger or an experience that they've had. And so on paper, that might look pretty bad. But what we want to try and do is figure out how they respond after that. If they are remorseful, if they are trying to repair or if they want to try and repair, whether they know how to or not. And so when they have that desire to repair relationships, then we can work with them. And the level of aggression is less important for us as long as we can be able to support them, obviously, if the situation requires it. And that may include extra staffing or just more support. And so the fit really comes, even if they get aggressive, where we can actually work and heal the trauma and then get them past that. Because once the trauma's healed, then those behaviors do go away along with it.

SPEAKER_00 4:23

It's a solid response. Okay. How do you balance urgency from families with making thoughtful, ethical placement decisions?

SPEAKER_01 4:32

That's a good question. That is a difficult one at times because when the families are in crisis, they're trying to find something that can get them out of that crisis as quickly as possible. So right at the beginning, we're explaining how the whole process looks. So if you're familiar with Uber and a lot of rideshare apps, one of the things that they do is they show you where your car is and how close your car is getting to you. And it doesn't matter really at that point whether it's five minutes or 20 minutes. You know where your car is. And so even if you're in a hurry, 20 minutes isn't that big a deal because you can see your car coming. And so we start the process that way. We tell the parents and the families exactly what the process looks like, what we need to be able to do to make a good decision, and also just bring them through that process so they understand what step along the process we're in and what else that still needs to happen. So if we got a call from a parent today, one of the things that we talk about is we've got to get the application done. We've got to get the clinical documentation so that we can see how things have happened in past treatment. And we've got to get that interview scheduled. And so we've got times available for those consistently. And so we'll get them on the calendar right away. And then they'll know that as soon as that interview's done, that we'll be able to make a decision on whether or not we'd be able to accept them or not. And so following that, there's some funding things that have to be worked on. But also that's part of the discussion at the beginning is once we approve, we've got to get the authorizations and contracts in place with the funding sources in order to be able to provide the treatment. And so they know right from the beginning what the process looks like and about how long it'll take. And that that makes it so that they can calm down and at least know that there's a good possibility of things working out.

SPEAKER_00 6:14

That's wonderful. Okay. So what's different about Habenwood's intake experience compared to typical residential programs?

SPEAKER_01 6:22

We put a lot into that. And that it's actually quite a bit of fun. So we kind of turned it into a competition, or at least I do. One of the fun things that we do is we dress up in their favorite color. And so we've got a bunch of staff in their favorite color. And my favorite color is not pink, but I've got pink clothes, I've got pink socks, and so we'll dress up in in pink. And I usually win the pink days. In fact, I lost for the first time this last week, and it wasn't pink, it was a blue color that I didn't have the right blue color for. So we'll dress in their favorite color. We've got their favorite snack ready to go. And also their favorite meal is on the plan from the chefs as well. And we'll try and play their favorite music as long as it's appropriate for treatment. And we just have a big team that's really welcoming at the time that they arrive to feel comfortable with the place. And so it's quite a bit different just in those ways, but we do a lot to find things out about them. And they get surprised most of the time with everybody in their favorite color, and they're saying, How did you know? And we'll talk about, you know, how we have our ways of finding things out. But we'll we'll do just about anything that we can to make them feel welcome. A couple other things. We've got another favorite stuffed animal. I just ordered one for intake on Monday that's coming here in a couple days. So try to do whatever we can to make it a good experience for them.

SPEAKER_00 7:42

That's really, really sweet. How do you set expectations so families don't confuse structure with punishment?

SPEAKER_01 7:48

Our whole program is built around relationships. And so we talk about how really safety is the only thing that we care about. So there are no punishments. One of the things that they might have to process through if they do break a relationship, they've got to learn how to repair that. And so that might take some time to process through. It might require some separation just so everybody can kind of calm down and work through that. And then as long as they're being safe, they're able to participate in anything. As far as what we're talking about with the parents ahead of time, we want them to participate in it as much as they possibly can. And so when they're missing out, it's on them. Like they're not being safe, so they can't go do an activity. And so that is really the only downside to them not being safe is that they don't get to participate in the activities which end up being quite a bit of fun. So the motivation is that they want to be able to work to keep themselves safe and go on the next activity and participate that way. So a lot of programs will have points and levels where they get points for good behavior or lose points for bad behavior. That doesn't work with someone with trauma and someone that needs to heal in a relationship. And so we have stages that they work through as they progress through relationship. We have different parts of relationships that they work through throughout the program, starting with orientation and then safety, where they're learning to keep themselves safe. Self-work is the next one. So that's when they're really focusing heavily on themselves and what they need to do. And then relationship work is they start to move into those relationship pieces and interacting with others appropriately and understanding how to give into a relationship as well as receive from a relationship. And then reciprocity is the last one where they're where they're really understanding that and modeling it. And so that's where most healthy relationships sit, is in that reciprocity stage.

SPEAKER_00 9:37

Awesome. So what common misconceptions do families have about residential treatment that you often have to correct?

SPEAKER_01 9:44

I think kind of the difficult piece there is I think a lot of times they don't want to send their kid to a treatment center. Like they want to try and fix it at home. And in some cases, there might be some outpatient pe things that can work. But once you reach the point of needing residential treatment, there's really nothing else that will work. It just takes a high level of structure and a lot of support. For example, we've got usually a one staff to two student ratio in the program at any time. And that's not something you can necessarily do at home even 24 hours a day. And so sometimes there's just a higher level of support that's needed. One of the common questions is how are you going to work on attachment when I'm a thousand miles away? With I'm at home as a parent, my kids there with you at Havenwood, a thousand miles away. How are we going to work on attachment? And the part that's the most important there is that the families are able to understand that we've got pieces that can help with that. So we've got family therapy, video calling that they can participate in. And we have them come for visits as much as they're able to. And so there's a lot of pieces that we can work on. But I think that's probably the biggest one is just how are you going to work for an attachment with maybe in so far away as the parent. And that's we we've got a lot of focus around that and through the family involvement and the pieces that they can participate in. We've got parent retreats three times a year where there's a lot of training that happens. And they also have the opportunity to come and work with other parents and other families that are going through the same thing as them. And so a lot of power is gained from that, as well as just more time to be working as a family together.

SPEAKER_00 11:21

All right. Awesome. So how does relational motivation factor into admissions decisions?

SPEAKER_01 11:27

So one of the things, as we talked about, is the interviews. And that's something that doesn't show up on paper. That is something that we do have to get from the face-to-face interview that we're doing with them. And with the questions that we ask, we can actually pull that out and figure out kind of where their desire is. And it's they're not leading questions, so they don't know what we want them to answer, but just different parts of relationships and how they've reacted and responded in the past and kind of what they want to be different and going forward. And so we're able to pull that out in those interviews. And that's why they're so important for us, especially on a higher acuity case, where on paper, you know, it might not be a good fit, but we can actually find out from the interview that it'll actually work. And so we'll we'll change our mind on those cases. That one's been a lot of fun to see just an actual interaction, change our minds on a decision and and then have them be successful while they're here with us.

SPEAKER_00 12:24

Awesome. Okay. What happens when families choose Havenwood for the right reasons? And what does that change?

SPEAKER_01 12:31

So one of the most important factors in treatment and the most important ways to be successful is when we're on the same team. And so when you say right reasons, I guess my first thought would be like they're bought into what we provide and they really understand that it can make a difference. And then we become a team. So one of the things we talk about is if there were to be a disagreement between us, it's really important that we get together and figure that out together as if we were co-parenting together so that we can, you know, make a difference in the child's life. And then if we disagree, we can't disagree in front of our kids, right? And so we want to be able to get that resolved, come to a resolution, and then have a united front to be able to support their child. And so I think when when they're choosing for the right reason, that's really where our relationship can be effective is when they understand what we do and what we can help them with. And then they make that choice on their own to to work with us together as a team.