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If you have had someone you love abuse drugs or suffer addiction to a substance, you will recognize the heavy price that is paid by the abuser and those close to him or her. One powerful way to help a teen or someone else break the denial around their substance abuse is to help them tally up the cost of their substance abuse. Help them to simply look at the price they and their loved ones have honestly paid and see if drug abuse is worth the cost. By completing this simple exercise, the abuser/addict and loved ones will be more able to see the heavy price and make a more determined effort to do something about it. First, think of the relationship of the drug and the abuser as a friendship because that is exactly what it becomes—a dependent friendship. In fact, it is more than a friendship; it becomes a love-trust relationship with full addiction. An affective way to look at this is to imagine that the relationship was an actual person—a friend. Suppose that friend (the drug) was a really cool person, and that it came to you and offered to be your friend; offered to let you be part of his or her close core of friends. Whenever you were with this person, you would feel popular, important, and confident. Life would be exciting, always upbeat, and fun. Through this person, you would be introduced to other people who were also fun and exciting. No longer would you be the loner, the outcast, the loser. You would be popular, at least with a certain crowd. You would be someone, instead of a nobody. This friendship, of course, would come with some expectations, even demands. The person’s friendship would require that you give total loyalty and priority to them and no one else. It would require that you be truant from school at times, fail classes, maybe even flunk grades, get suspended, or drop out of school. You would need to give up family activities and endure strained, even hostile relationships with your parents and siblings. You would also need to give up the activities and interests that you used to participate in and enjoyed for this friend. You would need to give up old friends who didn’t fit in with your new friendship. You must be willing to steal, defraud, or burglarize even your family and friends, and you must be willing to break the laws, get into trouble, and even give up your personal freedom for this friend. It may even require that you give up physical and emotional health, although the friend would tell you that his or her friendship would never hurt you. Also, you must be willing to sacrifice your values and beliefs, join gangs, carry weapons, and deal with occasional feelings of paranoia, irritability, and anxiety. Of course, your new-found friend would never tell you openly that the friendship would require all these things from you. Your friend would pacify you by telling you how much fun you will have, how free and happy you will be, and all the reasons why you deserve to have this friendship. Willingness to pay the price of the friendship would usually come a little at a time until the friendship had become addictive and you had no power to resist. Is this a friendship that anyone of sound mind would even consider entering into? Surely not. The price is simply too high. The only people that enter into this kind of friendship are those who are angry, defiant, self-destructive, hopeless, friendless, or who are desperately seeking an outlet from very significant problems in their lives and see no other options. Now, tally up on a sheet of paper the actual costs that you and your drug-abusing child are paying for this friendship with drugs. There are at least nine categories of costs that should be considered. Assign one point to each of the costs in each area; then, total the number of points for each area.
After tallying the costs of a friendship with drugs, decide if it is worth holding onto. If you decide it is not worth the cost, decide how you are going to have the courage to end the friendship. This is not as easy as merely telling a peer that you can no longer hang out with them or find new friends. Drug addiction simply doesn’t let go that easily. Its loss leaves a formidable hole in the lives of its victims. It lingers with strong urges, cravings, and obsessive thinking. It can fill a soul with dark depression, fearful-even painful-withdrawals, and hopelessness. The abuse of drugs does not resolve the problems or challenges that may have caused the original abuse. Physical and emotional pain, need for acceptance, impulsivity, and other reasons simply go into hibernation during the cold winter of abuse. When the thawing comes—if it does—the old challenges may revive, and the youth’s capacities to deal with the problems are at least no more developed than they were when abuse first began; usually have diminished. Unless surrounded by honest, firm, and supportive people, the victim of drug addiction often is caught in a terrible bind where they cannot afford to keep the addiction but cannot bear the pain of letting it go and will relapse. The road to sobriety is not merely abstinence, but includes going beyond abstinence and finding spiritual and emotional healing.

An adolescent enrolled at Provo Canyon School enters a continuum of care that extends over time.  Mental health care at Provo Canyon School does not imply warehousing or getting a child off the streets and into a safe haven for a period of time.  It does not imply “fixing” a child so they don’t engage in dangerous or self-defeating behaviors.  Care for Provo Canyon School care givers means a process of working with clients to help them recognize and accept their problems, successfully commit to and make important life changes in thoughts, feelings, behaviors, and relationships, and to sustain these after residential care has ended.
Clients mistakenly believe that bringing about positive change is an event that happens at one definable point in time.  However, long experience in the mental health industry has taught care givers at Provo Canyon School that real change takes a lot of work and has various phases.  The purpose of this article is to explain to the reader this continuum of care and why each phase is vital to the long-term welfare of the adolescent.
CONTINUUM OF CARE
Residential care at Provo Canyon School is a continuum of care with five major phases or processes.  Each phase plays a specific and important role in the overall growth and development of the adolescent.  It has been discovered that when one or more of the phases is skipped or not effectively completed—cut short—for whatever reason, relapse and recidivism of dysfunctional behavior is more likely to result. 


Admission and Intake Process
The first contact a client and family have with Provo Canyon School is critical to the future course of treatment.  It is very important to ensure that the client is appropriate for admission and that adequate care can be provided.  After consent for treatment is obtained, the beginning of a therapeutic alliance takes place while the proper information and paperwork is gathered.  The parent’s willingness and ability to provide the intake staff at Provo Canyon School complete and accurate information facilitates proper preparation and planning for the client.  The staff understands the stress and anxiety that comes with placing a child in residential treatment, and they are prepared and desirous to help parents by providing information, giving assistance in administrative matters, and offering morale support.
    Admission personnel will be the first people to ask questions about the needs and situation of the client.  This information is provided to the intake team so that the client can be admitted smoothly, safely, and with the least amount of trauma or disruption.
    The intake team at Provo Canyon School meets the client and parent(s) and attempts to make the intake process as painless as possible.  They also seek to gain key information about the client and his family.  If parents do not accompany a client to the Provo Canyon School, team members make telephonic contact with the parent(s) to gain this information. 
    The intake team at Provo Canyon School includes nurses, the psychiatrist, teachers, team therapist, and intake coaches.  Each intake team member talks with the parent(s) to gain insights and information about perceived needs and concerns.  Nurses determine health requirements and critical issues; teachers gain school and current academic standings; therapists gain information about the child’s biological, psychological, and sociological history; and team coaches want to know about behavior and attitude challenges that may exist.
    The admission and intake phase is the time for parents and staff of Provo Canyon School to begin a trusting and supportive relationship together.  Parents are considered to be part of the treatment team because they have valuable information and insights, as well as a vested interest in their child.  Parents should come to trust the intake staff and support them in their efforts to help their child.  When this phase of care is not well handled, or a relationship of trust and mutual respect is not well established between staff, parent(s), and adolescent, the outcome of successful treatment will be diminished and perhaps sabotaged. 

Assessment and Orientation Phase of Care
Provo Canyon School’s treatment team’s first major tasks are to provide safety and comfort to the client, to help the client adjust to program expectations and procedures, and to identify needs that can be accomplished while in residential care.  This is a time when the staff attempts to empower trust and openness in their clients and supporting families. 
Clients at Provo Canyon School begin their care in an orientation phase while their personal belongings are inventoried and assessments, evaluations, and orientations take place.  The psychiatrist meets with each patient to make a diagnosis of needs and to determine the need for any ongoing or new medications.  Nurses assess medical needs; the client is tested for intellectual capacities and school grade placement by certified testers;  team therapists complete a psychological, biological, and sociological evaluation and formulate a treatment plan with needs, goals, and strategies identified; a orientation coaches begin to educate and train the client on core beliefs and values that their team operates by, and the standards of excellence (problem management skills) that they individually need to work on.  Coaching requires trust and mutual respect, as well as personal accountability, and the entire treatment team seeks to promote this in their team.

Primary Care
When the treatment plan has been prepared and the client is adequately trained and oriented to Provo Canyon School’s procedures, they begin to more directly participate in the full school program.  The client is assigned to a team and begins to live and interact with other team members.  The client’s treatment plan is implemented by the treatment team, and he or she begins to engage in school, team meetings, chores, activities, and therapy.  The entire treatment team, including the client and parents, are oriented toward specifically identified goals—called problem management skills—that the client and parents are to achieve.
The client is placed in a team of 10-11 teens and a therapist and coaches.  Everything happens with the team, except school.  The client is expected to help identify and accept personal problem areas that they have not managed well, and to learn from coaching and therapy new skills on managing these problems as they live at Provo Canyon School.  As the client learns by taking accountability for his or her choices, they learn to develop these skills that empower them toward a more rewarding life style.
Primary care includes every aspect of Provo Canyon School’s team: therapy, group therapy, recreational therapy, family therapy (often by phone), substance abuse treatment, coaching, work opportunities, school, medical and nursing care, vocational training, and dietary/food service care.  Provo Canyon School provides one of the richest and fullest treatment environments in the nation.
A client advances through the program by achieving statuses or levels that allow for greater privilege and trust.  Advancement requires that they show the development of skills and abilities to live the core values and manage their behavior and attitudes by the application of problem management skills (standards of excellence) in various settings.  Status advancement must reflect more than a client’s attempts toward outer behavior to avoid consequence or to gain privilege, but it must reflect a deeper change or growth in attitudes and beliefs and self-concept.
Provo Canyon School staff often refers to these living skills as powers because they reflect powers that a client must exercise to have a good quality of life.  For the client at Provo Canyon School to successfully advance in the skill areas, they naturally must demonstrate the acquisition of powers that include (1) identifying and accepting problems that need correcting, (2) making an emotional commitment to change, (3) making actual changes in beliefs, thoughts, emotions, behaviors, and relationships, (4) forgiving and healing from the past, and (5) sustaining the life skills and change.  When this part of care is cut short or diminished by conflict between parent(s) and staff, the plausibility of the client making true inner changes is significantly diminished.

Transition Care 
Transition prepares clients and families for discharge or transfer to a less restrictive level of care.  Residential care at Provo Canyon School is rigorous enough that clients need a period of preparation to handle the home’s lesser structured environment.
The transition program simply provides the client with a less structured environment while maintaining the same or higher level of expectation for living by the standards of excellence and managing their life’s problems in a productive manner.  A client at Provo Canyon School is deemed ready for transition when they have demonstrated over some time that they can self-regulate using the skills and powers gained in the program.  Provo Canyon School care givers do not expect perfection from teenagers, but they do expect reasonable performance.  
Clients on transition live at a different facility, they manage their personal time more by themselves, and they engage in more activities.  Meanwhile, they are expected to maintain or even improve their school performance, their team leadership, service to their team, their personal standards of excellence, and their personal aftercare plan.  This is an important part of treatment that many parents or third-party payers do not respect enough.  This is the preparatory phase where clients and parents prepare to reunite, and when sufficient time and effort is not given to this, the potential for relapse or recidivism is increased and the work done at Provo Canyon School diminished.

Aftercare 
When a patient leaves Provo Canyon School to return home or to go to a less-restrictive care place, care moves into what is referred to as aftercare.  Aftercare begins at time of discharge, but aftercare planning begins with admission.  Provo Canyon School care givers are thinking about discharge from the very beginning.  As the treatment process moves along, parents, youth, and staff become involved in making decisions about what is best when treatment at Provo Canyon School ends. 
The entire treatment team is involved in the aftercare planning. At the time of discharge, the attending psychiatrist orders medication through a discharge order.  When recommended as part of the Continuing Care Plan, the initial continuing care appointment is made for both psychiatry and for counseling/substance abuse care.
Aftercare planning involves (1) where the patient will live, (2) where will they go to school, if appropriate, (3) what vocational training might be appropriate, (4) What rules of engagement might be necessary with parents, family, and friends, (5) follow-on treatment for mental health, drug and alcohol relapse prevention, and (6) spirit, recreation, social, and emotional goals.  It is also an important time for parents and family to evaluate themselves and the environment of rules, values, and procedures that they have at home.  They must be prepared to receive the child back home and maintain some semblance of structure.
 A discharge summary should be entered into the patient's medical record within fifteen days following discharge.  This summary should include a clinical resume which concisely recapitulates significant findings, the course and progress of the patient with regard to each identified problem area, the clinical course of the treatment rendered, and the final assessment (including the general observations and understanding of the patient's condition initially, during treatment and at the time of discharge).
Provo Canyon School staff remains interested in the client when they return home, and often clients remain in touch with staff from the treatment team, especially during important life events.  Aftercare planning is crucial to maintain stability and continued growth.  When this phase of care is neglected, the potential for relapse is significant.

It would be easy to not expect much out of teenage boys who come to Provo Canyon School.  After all, most of them have been in trouble in school, with the police, or into serious drug and alcohol abuse.  They might be passed off as simply delinquent teens with conduct disorders.  So, when a large group of boys from Provo Canyon School showed up at a local church in Provo, Utah to help in a Christmas service project for Native American Indians in December 2005, many were apprehensive as to their work ethic and ability to contribute without disruption.

Ron Albert, a senior shift staff for the boy’s campus at Provo Canyon School, discovered the service opportunity and believed enough in the boys and the value of service that he put the reputation of the School and his own on the line by signing up.  During 2004 and 2005, Provo Canyon School had implemented service to others as a key value in their program of excellence.  Assisted by other staff of similar heart, Ron met with the teams of boys and their staff to explain the importance of the service project and to solicit their commitment to serve.  Of course, most boys were willing to participate because it offered an opportunity to get away from the structure of the School.  However, they soon discovered that the service project would be on a Saturday, and that they would have to get up at 6:00 a.m. (they normally get to sleep in until 9:00 a.m. on weekends) and eat sack lunches if they wanted to participate.  This represented a sacrifice for the boys of Provo Canyon School because Saturday was a day off from the rigorous routine of school and therapy at the school.  Saturday and Sundays were the two days in the week that the boys could kick back, play outside, and enjoy a little time off.

Ron and others explained to the boys what the service project was about and the important service that it offered to Native American tribes.  Many Indian families on reservations in surrounding states were poor and had no means to provide their children a meaningful Christmas.  Each Christmas season, the Native American Association provided a Christmas for them by arranging for truckloads of donated fruit, candy, clothing, toys, and other items to be delivered to the parking lot of a church in Provo not far from Provo Canyon School.  All of these items were wrapped and separated by Indian Tribe to which they would be delivered. That Saturday morning, trucks would come from Indian reservations in surrounding states: Nevada, Utah, Arizona, Colorado, even as far away as New Mexico, and picked up their packages and delivered them to needy Indian families that, otherwise, would have no Christmas.  It was a well-planned project that required hard work and timeliness to meet delivery and pickup schedules.

The boys of Provo Canyon School responded with enthusiasm despite the early wake-up call and hard day’s work.  Approximately 40 boys participated, and others would have done so if allowed.  Provo Canyon’s food service prepared early breakfast and sack lunches for the boys.  Transportation was arranged, and staff put in extra time to come and work with the boys.  Soon, the boys of Provo Canyon School arrived on the scene and totally blew away all skepticism that may have been in the minds of those organizing the project.

One group of boys went inside the building and joined a large team of women and men putting boxes together and wrapping packages of toys and clothing in bright Christmas paper.  These packages were placed in containers designated for each Indian tribe.  Outside, in the cold, other boys from Provo Canyon School quickly organized and plunged into the semi-trucks with arms and dollies. Few if any of the boys had to be coaxed or disciplined by the staff.  Every young man was eager to do his part.  Within a very short period of time, the semi-trucks were unloaded and the parking lot was stacked with boxes of items.  The project manager was staggered by the speed.  He said to the staff, “In past years, it took us almost six hours to unload the trucks because we had only a few volunteers, and most of them worked pretty slowly.”  The Provo Canyon boys did it in a fraction of the time.

It would not be long before the trucks began to arrive that would take the packages to the various Indian reservations.  Under the staff’s direction, the boys from Provo Canyon School were quickly divided into teams and began the next phase of the work.  All the boxes had to be sorted and divided out among the tribes.  Placards with the Indian tribe’s name on it were placed along the curb of the Church’s parking lot.  Each tribe was to receive a certain number of boxes of food and fruit.  The Provo Canyon School boys moved back and forth between the large stack of boxes and the placards, carrying heavy boxes and sacks of items.  Staff and some boys checked off the quantities, while other boys did the heavy work of moving the items.

Again, the work was done in record time.  The boys worked together as a team in cooperation, only taking brief breaks for hot chocolate.  Piles of oranges, apples, and other fruits and vegetables were separated by Indian tribe, along with sacks of toys and other presents.  The job was done in enough time that the boys from Provo Canyon School had time to rest and drink hot chocolate before the delivery trucks began arriving.

One at a time, the trucks pulled up and were quickly loaded by the boys with all of the packages and boxes designated for that Indian tribe.  And when the work was completed, the boys had worked hard and felt good. They had lost out on sleeping in, on a hot breakfast, and on playing football and other games outside with their peers.  The work had been hard, but despite all of this, each boy felt something good inside of them because they had given of themselves to help someone else.

As the boys were loading back onto the bus to return to Provo Canyon School, the director of the project approached Ron and asked if he could talk to the boys.  He entered the bus and with emotion in his voice and tears brimming in his eyes, he told the P.C.S. boys about the Indian children and families that would have a wonderful Christmas because of their sacrifice.  He praised the boys for their hard work and dependability.  He had thought that they would be lazy workers and hard to control because they were supposed to be “troubled boys” from Provo Canyon School.  But he had misjudged them; they had proven him wrong, and he was noticeably touched.  In past years, the project had taken 12 – 16 hours, sometimes longer, to complete.  The Provo Canyon boys had finished it by early afternoon.  The director was profuse in his praise of the boys.

The P.C.S. boys had time during the return trip to Provo Canyon School campus to reflect on their individual feelings.  It felt good to be complimented—even praised—by others; so different from past years of being in trouble and feeling worthless and discouraged.  The thoughts of little Indian children joyfully opening the boxes and toys that the boys of Provo Canyon School had helped to assemble and package helped them realized their own blessings. Despite being away from home at Provo Canyon School, each boy to recognize that they were truly blessed.

Provo Canyon School adopted the core value of service to others to teach this very principle of true living.  Special things happen when boys and girls help others without receiving monetary remuneration.  First, they feel good about themselves because they helped someone in need.  Compassion is a natural human feeling that can be touched and awakened by service to others.  Second, self-esteem is enhanced through service to others.  Youth often feel that they are of no worth to others.  Their self-esteem and self-confidence in contributing meaningfully to others is measurably strengthened as they see their efforts bringing joy and gratitude to those they help.  Third, awareness of ones own blessings is enhanced by helping others.  Expressions of appreciation and happiness by those who are the benefactors of service inspire the same feelings in those who provide the service.  We cannot help others without receiving the same blessings.  Last, service helps overcome selfishness, self-centeredness, and the harsh influences of society that canker children’s souls.  Service is like meat tenderizer to the soul, removing the tough, mean, insensitive, and even harsh natures, and making them sensitive, thoughtful, and kind.

A few weeks after the service project for the Native American Indians was over, a beautiful thank you card and remembrance arrived at Provo Canyon School.  An Indian artisan had created a remarkable sand painting called “Navajo Boy” just for the boys of Provo Canyon School.  The painting was a backdrop of red-brown sand of the desert mixed with red, buff, black and turquoise-colored image of an Indian boy.  An explanation was written on the back panel, and the entire drawing was framed in gray-colored, weathered wood.  The Native American Indian Christmas service project has been so successful that the P.C.S. boys have participated in it each year since that time. 

Ask any direct-care staff at Provo Canyon School what is the single most important factor in helping adolescents make important changes while in care, and they will almost without exception say: healthy relationships. When healthy relationships are formed during treatment at Provo Canyon School, remarkable growth occurs in a client and the client’s family. Relationships of trust and mutual respect can be challenging to achieve, and are fraught with potential opposition.  When a relationship of contention and distrust emerge, treatment is frustrated, and can result in complaints and even accusations of abuse. 

Provo Canyon School Relationships begin with individual people. While there are many important people involved in the care of a teen in treatment at Provo Canyon School, three individuals or groups of individuals are crucial to the success of Provo Canyon School treatment. These three individuals or groups are shown in figure 1 below and include: the teen, the parents/family, and the Provo Canyon School treatment staff. The teen, labeled “T”, is the driving reason for all relationships in care. The teen comes to Provo Canyon School treatment in crisis, often filled with resentment, confusion, and resistance. Parent(s) and other family members, labeled “P”, come also to the relationship in crisis with feelings that often include pain, sadness, guilt, hopelessness, and disillusionment. The Provo Canyon School professional care-giving staff, labeled “S”, receives a client (and the attached family) with minimal background history or prior relationship with the teen or parents, and must begin from scratch to develop a profile of needs and a helpful treatment plan. Thus, at the beginning of Provo Canyon School treatment, all three groups of people have little or no relationship, and what happens or fails to happen between them in terms of relationships will inevitably determine treatment outcomes. 

Provo Canyon School believes that each person is important to success in care; each has an affect upon the success of treatment. The influence of these three individuals or groups can be helpful, hurtful, or insignificant depending upon how they play their roles. The teen (T) needs to focus at first upon themselves and their treatment program. Often, they seek to avoid needed change by engaging in blaming, denying, splitting, and refusing responsibility. Parents and family members (P) should play a supportive role, not a controlling one. Progress is most effective when parents and family focus on their own growth needs, but sometimes they want to focus only on their child’s progress, instead of their own. The Provo Canyon School professional staff (S) seeks to help client by implementing treatment plans and procedures. But if they are not watchful, they might fail to nurture important relations with parents and other key people in the client’s life.

The Power to Help or Hurt: Each of the three key people or groups of people (represented by the three points of the triad) has the capacity to help or hurt the treatment process at Provo Canyon School by influencing the important relationships that must form if treatment is to be successful. No person of integrity would consciously seek to sabotage a teen’s success in treatment, but sometimes ulterior motives or failure to see the vision of the process prevents full power from being achieved. The relationships are represented in figure 1 by the three sides of the relationship triad, and are labeled: P-T, T-S, and P-S. The forces exercised by each individual in the relationship are represented by the dotted black arrows in the diagram.

The teen (T) has the power to affect relationships between self, staff, and parents. He or she may attempt to exercise force against the relationship between the parent and Provo Canyon School staff (P-S) because they feel threatened by that alliance. Resistance from the teen often comes in the form of claims of abuse or misbehavior by the staff made to the parents. Provo Canyon School staff actions are embellished into mountainous claims of abuse, and if any distrust or uncertainty exists between parents and staff, this fuels the fire. When a trusting and mutually respectful relationship exists between parents and Provo Canyon School staff, these concerns can be openly discussed and resolved, and the teen can more quickly settle down and focus on the work to be done.   

The parent (P) influences relationships between themselves, their teen, and the Provo Canyon School staff. Some parents never gain trust and respect for the staff, and vice versa. Infrequently, a parent tries to sabotage the relationship between their child and the staff because of feelings of distrust, guilt, shame, resentment, or fear of having to make their own changes in life.  When a parent interferes with a relationship between their teen and Provo Canyon School staff by trying to referee and manipulate, their teen’s progress in treatment comes to an abrupt halt, and he begins to retrogress. When parents support the Provo Canyon School staff and resolve concerns without the involvement of their teen, the treatment progress can continue.

Likewise, staff (S) can either promote or harm the relationships between themselves and the teen and the parents. Provo Canyon School staff has an obligation to treat all clients with dignity and respect, and to cultivate relationships of trust.  When staff include the parent(s) as a legitimate member of the treatment team and earn their trust and confidence by keeping them informed and involved in the process, most parents will respond in a positive manner.

A closer look at the interaction of these three relationships helps us understand how important they are in the outcome of care.

Teen – Provo Canyon School Staff Relationship: The first and most important relationship to success in treatment is the one that develops between staff and the teen. It must develop over time, and is not a friendship, but a mutual trust and respect. Staff at Provo Canyon School has an obligation to hold a student accountable for their choices, while attempting to help them see and make needed improvements. If a relationship of accountability and mutual respect does not form, it is highly unlikely that positive growth will occur. For this reason, successful parents do not resent positive relationships that form between their child and the Provo Canyon School staff, and they do everything possible to promote and encourage this relationship. Parents that rescue their children by interfering with this relationship diminish the potential for their child’s true growth. Provo Canyon School provides an environment of care and concern, but also one of discipline and accountability. It seeks to empower a teen to see the problems that need correcting and to take responsibility to work on them. The student experiences accountability by being taught positive growth principles, making daily choices, and receiving consequences. It is not a perfect system because people are not perfect, but it is a proven system, and helps teens to grow. Wise parents do not necessarily buy into their teen’s complaints or accusations, but encourage them to work it out with their Provo Canyon School team staff. Legitimate concerns arise from time to time during treatment, and these should be honestly and frankly discussed between staff and parent outside the presence of the teen. Staff has a responsibility to respond to a parent’s concerns, and recognize the parent(s) as valuable and essential members of the treatment team, and to strategically include them in the process. 

Parent – Provo Canyon School Staff Relationships: The second most important relationship in treatment at Provo Canyon School is that between parent and staff. Both parents and staff must work to establish a relationship of mutual respect and trust. This is challenging because parents find it difficult to give up care for their child to another adult, and staff may feel that parents are interrupting their work with the teen. Trust is best formed when treatment staff views the parent(s) as resources and members of the support team, and not liabilities, and parents view treatment staff as professionals, and not threats. A patient would not presume to tell a doctor how to conduct their appendectomy. Neither should they presume to tell a mental health professional how to perform their duties. Rather, a state of openness and mutual respect must be earned through direct and honest communication. The parent-staff relationship is especially vulnerable in the early phases of care when trust and confidence is just beginning to grow. The child will attempt to take advantage of this tenuousness by sabotaging and undermining their parent’s trust in the Provo Canyon School staff so that they can manipulate their way out of responsibility and growth. If a child can create distrust in the minds of parents for treatment staff, they can successfully jam the treatment process and escape accountability. The staff-parent relationship is a prelude to success or failure of treatment.

Parent – Teen Relationship:  The relationship between parent and teen is an outcome of the other two relationships. The relationship between parent and child cannot be forced or rushed in treatment. Indeed, a healthy relationship between teen and child can only come after the development of the other two relationships. It is the goal of treatment to establish a healthy parent-teen relationship if possible. At the time of admission, the relationship between the child and the parent(s) may be significantly stressed and often not healthy. If parents wrongfully sabotage Provo Canyon School staff and their relationship with the teen in order to try to obtain the love of their child, they are sabotaging their child and their relationship with him or her. Successful parents realize that the first task is to help the teen take responsibility for their own treatment program. Parents that show unconditional love, but require the child to earn their respect and trust by being accountable, do their children a great favor. Parents play a support role, not a control role. Successful parents recognize that for a healthy relationship to develop between them and their child, they must work on their own issues, even as their child works on his/her problems. If they find themselves trying to control treatment, not following the professional guidance of the Provo Canyon School treatment staff, and disregarding treatment protocols, then, they are too enmeshed with their child, and are actually harming the success of the treatment.

Each child in treatment is part of a team of peers and selected Provo Canyon School treatment staff. The team becomes the core of the growing environment. In the program they learn and practice the core beliefs, core values, and standards of excellence that measure meaningful growth. If the relationships between parent, teen, and staff are developed, growth within the team environment will come faster and with far less pain and concern. In the final analysis, the quality of relationships in treatment between key people will determine the quality of growth in the teen. 

Here are some thoughts on effective communication.

Tips for Effective Communication