Friday, May 28, 2010


The Treatment Team

Sorenson’s Ranch School has adolescent clients with a variety of presenting concerns including Oppositional Defiance, Substance Abuse, PTSD, behavioral problems, school problems, Attention Deficit Disorder, mental health problems, Bipolar Disorder, Depression, Borderline Personality Tendencies, and unresolved adoption issues, including Reactive Attachment Disorder. Because of the variety of presenting problems that our adolescent students display, it is important that we individualize their treatment. Each student has a treatment team that consists of their parent(s), their therapist, case manager, and her/himself.

The therapist is designated as the leader of the treatment team. The case manager will serve as the parents’ primary point of contact. They will speak to the parent(s) each week about their child in order to provide an update on how their child is doing in the program: including how they are doing following rules, interacting with staff and other authority figures, interacting with peers, performing in school and other extra curricular activities, and working in individual and group therapy. The case manager will be aware of how the student is doing in therapy due to the fact that the case manager and therapist “crossover” about how the student is doing in the program each week. However, the therapist will also contact the parents on an approximately every other week basis in addition, to provide some more detailed information regarding how the therapy process is going and to elicit useful relevant input from the parent(s) to assist in the therapeutic process.

There are times when students get caught up in comparing what their case manager, therapist, or parent(s) is/are doing. For example they may say “why is my case manager doing such and such when somebody else’s is not, or why is my therapist requiring this of me when someone else’s is not. It’s important that the treatment be individualized to the particular student. We encourage students not to worry about what any other case manager, therapist, or set of parents is doing, but to focus on their own work here at Sorenson’s Ranch. It should be noted that although the primary adolescent treatment team consists of the parent(s), therapist, case manager, and student, every staff member here at Sorenson’s Ranch is an important part of the student’s treatment. Group leaders, teachers, residential staff, cooks, ranch and maintenance workers, and administrative staff are all essential in playing their specific roles in assisting the students who have behavioral, substance abuse, and/or mental health problems.

It is natural for the student in treatment to want to know how long they will be in the program. Although parents are tempted to give their child a clear answer in hopes of motivating them, it has been our experience from working with thousands of troubled adolescents over more than two decades that how this question is answered can make or break the student’s motivation to actually engage and apply themselves fully to working on themselves and making real progress in the program. We feel strongly that the best answer to this question is to tell them that their length of stay is dependant on their actual progress in the program and that you are relying on their therapist to let you know when they have completed the program. The therapist will develop a treatment plan that includes treatment plan goals and objectives/interventions to assist in meeting those goals. It’s been our experience that if students do not believe that their discharge date is completely dependent on their actual progress, they will not work as hard, instead hoping that their parents will discharge them prematurely or at a designated point of time, or that their parents will “run out of money and discharge them regardless of their actual progress.” If you have any questions about what to tell your child about discharge, it is recommended that you talk to the child’s therapist about it before speaking to your child about it.

In addition to individual therapy, students receive group therapy weekly. We have groups on a variety of topics: including Teenage Substance Abuse Intervention/Prevention, Anger Management, Adolescent Dialectical Behavioral Therapy, Adoption, Grief, Sexual Abuse and Rape Survivors, and Yoga/Meditation. Students may be participating in anywhere between two and five or more groups at a time depending on their specific needs and inclusion in the categories mentioned above, such as being adopted or being a sexual abuse or rape survivor. As therapists and case managers, we need and appreciate the participation and input from parents as one of the key members of our treatment team. We are open to questions and/or feedback regarding how we are working with your student and encourage you to work with us collaboratively on helping your child. Any questions or concerns are welcome.

Thursday, May 20, 2010

A horse, a horse! My kingdom for a horse!

The Berkshire Juvenile Court in Massachusetts has found an imaginative way of dealing with troubled teens that have had some minor run-ins with the law. Instead of sentencing these teens to highway cleanup for their minor offenses, the Court sentences them to participate in a 10-week performance program with the Shakespeare and Company. The program is called the Shakespeare in the Courts Project.

This innovative program forces troubled teens to step outside of themselves and learn skills the heretofore would never have considered. The goals of the program are to encourage group participation, develop listening skills, self-esteem, responsibility and commitment for a project, leadership skills and to foster a sense of accomplishment.

These are some of the same goals we hope to accomplish with our teens here at Sorenson’s Ranch School, but instead of learning to perform Shakespeare, they learn horsemanship skills in order to perform and compete in local 4-H competitions. The 4-H program encourages group participation as they learn together the ins and outs of how to care for livestock, how to ride a horse, and how to compete in local county fairs. Learning to ride a horse with a group of other riders develops listening skills as they have to pay close attention to what those around them are doing and saying as they train their animals. Winning awards in the 4-H competitions builds self-esteem and gives participants a sense of accomplishment.

Many of Sorenson’s Ranch School’s troubled teens have come from urban areas where they have never been near a horse or seen a buffalo. They have no concept of how food is grown or what it takes to manage a herd of cattle. It is their first experience in the processes of growing hay, from daily having to move large sprinkler lines to helping load the bales of hay onto the flatbed trucks.

Our country is faced with many troubling complex issues today, not the least of which is our youth, and with so many teenagers having difficulties Sorenson’s Ranch School commends programs like the Shakespeare in the Courts Project. Many families are in crises these days, and parents need all the help they can get. We at Sorenson’s Ranch School strive with great diligence to change the lives of those troubled teens in our care in order to give them a brighter future. So that one day they may “Be not afraid of greatness.”

Monday, May 17, 2010

Distress Tolerance Skills

Sorenson’s Ranch School’s behavior modification program offers students many opportunities to engage in basic fun, entertaining, and educational activities as they learn to change and manage their behaviors. All of these activities have a purpose in assisting teenagers in managing their behaviors. Managing their behavior is a skill they can learn with help from dedicated therapists and staff.
Sorenson’s Ranch School facilitates a skills group entitled Dialectical Behavior Therapy (DBT) developed by Marsha Linehan. The DBT group focuses on teaching skills to assist with developing Core Mindfulness, Interpersonal Relationships, Emotion Regulation, and Distress Tolerance. The majority of students at Sorenson’s Ranch School have difficulty in at least one of these areas; therefore, learning the DBT skills can be an important part of their therapy.
Distress Tolerance Skills are skills for tolerating painful events and emotions when you cannot make things better right away. Distress Tolerance Skills were developed to assist individuals who have a difficult time managing their emotions in handling situations that they cannot fix quickly, including: death of a loved one, intruding thoughts of a trauma, getting along with others, and tolerating a situation in which they are not getting their way. Many of the students at Sorenson’s Ranch school have difficulty managing their emotions, and are impulsive and defiant. The DBT Distress Tolerance skills are designed to help students manage life changing events and daily stress.
The Distress Tolerance skills focus on teaching students crisis survival strategies through learning distracting skills, which include joining in activities and contributing to others through service. Sorenson’s Ranch School provides daily activities for students to use these Distress Tolerance skills. A few of the activities include educational fieldtrips, campouts, cookouts, fishing, boating, fun games such as capture the flag, organized sports, and service projects on campus and in the community. These activities are designed to teach social skills, help them learn to have fun while sober, and offer the opportunity to leave one’s worries and problems behind for the moment, until they can be appropriately worked through.
What might look like just a fun, time-consuming activity for your student is really a well thought-out and planned activity that has a purpose in teaching your student lifelong skills to manage their behaviors and emotions. If you would like to learn more about the DBT Distress Tolerance Skills be sure to ask your teenager’s therapist.
Linehan, M. (1993). Cognitive-Behavioral Treatment of Borderlines Personality Disorder. N.Y.: The Guilford Press.

Wednesday, May 5, 2010

Addiction Recovery Support Groups

Each month there is a new topic in the Addiction Recovery Support groups at Sorenson’s Ranch School. The topic is this month is about the drug marijuana. “What is the big deal?” The students say. “It is just marijuana.” “Man, it is just natural.” “It isn’t that bad.” So, in groups we have drawn The Pot Circle on the white board. It all starts with boredom or a personal problem, so the individual decides to use some marijuana, and before long the individual finds that they are making some poor choices or taking inappropriate action. Their use of pot increases because they become discouraged about some of the consequences that they are experiencing. All of a sudden they are fighting with Mom and Dad. “You don’t trust me anymore.” “Your rules suck.” “I should be able to do what I want to, when I want to.” “It’s my life.”
The list goes on. So the pot use increases. Soon the report card comes out, and the teen finds out that they are failing in school. Maybe they lose their job. At home, problems increase with parents and following the rules. They don’t want to associate with parents or go to family functions. So in the Pot Circle all of a sudden the adolescent is dealing with failure and disappointment in their lives. Nothing is working out for them. So the smoking increases. It continues and soon they realize that they have reduced their options. The teen becomes more disappointed. They continue to hang out with people who are all in the same predicament as they are. Most of these adolescents by now have been kicked out of school, either for being tardy or being caught smoking pot at school, or other similar behavior. Maybe the teenager has failed so many classes that he/she is feeling overwhelmed and guilty. Thinking, “If they would just leave me alone, I was handling everything.” “If people would just back off and let me do it my way, it would have all worked out.” “It’s all my parents’ fault, or the teachers’ fault.” “Who needs all of that anyway?” “Man, we have the life.” “Who cares?” “ I just want to be left alone.” “Hey, you do your thing, and let me do mine.”
Teenagers sit around and talk about what they are going to do, but the motivation to go do it has left. So they continue to do more and more pot. “Why keep pace with those crazy people out there?” “All they’re doing is sticking it to each other.” “Why can’t they relax?” This brings us to the final spot in the Pot Circle, reduced motivation. So the Pot Circle becomes a vicious cycle. In the Sorenson’s Ranch School group discussions we ask the students, “Where are you in the Pot Circle?” “Do you think that you have a problem with marijuana?” “Where is your life headed?”

Monday, May 3, 2010

Sorenson's Ranch School Sleepovers

One of the fun things that average teenage girls like to do is have sleepovers. They enjoy getting together at someone’s house and doing girl things. They sing, dance, play games, eat fun food, and are able to relax enough to come out of their shells and be themselves. This is one of those ordinary activities during a girl’s formative years that a troubled girl misses out on. A night of wholesome fun with other teens her age is rare for a teen who is experiencing behavioral difficulties.
At Sorenson’s Ranch School girls are given the opportunity to be involved in wholesome activities. Every four to six weeks on a Friday night, we do a sleepover activity. Level Three, Four, and Five girls are invited to attend. We spend the evening cooking, dancing, doing crafts, facials, and watching movies. We choose a food theme, such as breakfast for dinner. The girls cook their own meals with their favorite ingredients. They can get very creative with their dishes.
We listen to music while we cook. They really enjoy dancing. There is a lot of laughter and fun as they teach each other dance steps. Sometimes we do karaoke, which can be very entertaining.
At the last sleepover we made bags from bandanas. The girls were creative in mixing patterns of bandanas. It’s fun to see their creativity. Many troubled teens with self-esteem issues do not realize how creative they really are. Sorenson’s Ranch School provides various opportunities for our teens to discovery their inner talents.
We sometimes have facials from homemade ingredients. They mix egg, honey, and olive oil. It’s interesting to see the reaction of putting such a concoction on their faces. They are always amazed at the results.
We bring in blankets and pillows, spread them on the floor, and settle in for a night of movies. We’re allowed to stay up as long as we want on that night. The girls really enjoy our sleepovers, and it shows them there are alternative ways to have fun. They learn cooperation, patience, and tolerance of each other in working together to create a fun night. They gain confidence in trying new things. They have a desire to achieve higher levels because no one wants to miss out on the fun.
This is just one example of the fun activities available for students at Sorenson’s Ranch School. As we move into the summer season, campouts will be a regular part of student life. Girls will be able to do many of the fun activities that they do during their sleepovers, but in an outdoor setting. Singing around a campfire is always fun. Troubled teens from urban settings are always amazed at how fun and enjoyable outdoor experiences are. Combining sleepovers with the outdoors, which is what a campout is, creates experiences that they will remember the rest of their lives.