The THRIVE Center™ For ADHD & Comprehensive Mental Health Care Of Central Maryland

 

Heron's Gate Treatment Services

Treatment effectiveness is rooted in relationship – among young adults in their peer groups, among parents in the parent support group, and among the clinicians, young adults and parents for all activities. These relationships thrive only when a high level of trust, safety and accountability is established, with personal growth evolving from this sense of shared responsibility and purpose.”

– Dr. Richard Silver

Heron’s Gate is comprised of a set of core clinical and administrative services, with other treatment interventions customized to the specific needs of the individual participant and his or her parents.

Although typically delivered over twelve months, the duration and comprehensiveness of services varies with the clinical status of the family. The program is highly responsive to real-time clinical demands and service packages can be renegotiated as needed. The Heron’s Gate Program requests a minimum three-month commitment for participating families.

Establishing structured, productive time for each Young Adult Kid (YAK) is a key goal of the Heron’s Gate programming. Activities are scheduled so the YAKs consistently get up in the morning; get ready for volunteer work, job or class; show up at the right time with the right attitude; and deliver several hours of productive service.

Groups For Young Adults

Functions Of Groups – The groups are one of the most important clinical elements in the Heron’s Gate program and function in the following ways:

  • To create a cohort or tribe that serves as the developmental “ship” carrying these young adults to the next phase of their lives. At this stage, parents and families of origin -- no matter how loving -- are decreasingly the appropriate reference for the creation of a healthy, autonomous self. Identity must develop through interactions with same-developmental-age peers. Typically, the young adults in the program have not been successful in establishing a healthy transitional social network, and therefore remain arrested in their movement towards the acquisition of adaptive life skills necessary for independent living. The Heron’s Gate groups provide this transitional social network.
  • To provide a safe environment to begin opening up emotionally and working through issues.
  • To provide a forum for practicing specific emotional and practical skills.
  • To allow participants to build and practice emotionally intimate and supportive relationships and communications.
  • To encourage accountability and responsibility to self and others through regular attendance and through review of progress on treatment goals. Participants learn that their showing up and actively engaging in the activities of the group are vital to the success of the group. Put simply, each person learns that they as an individual matter to the functioning of a larger community, and that their decisions impact the feelings and safety of others – they are an essential part of a team.
  • To provide a forum for support and feedback regarding personal issues, treatment goals and recovering from setbacks.
  • To allow participants to express and therefore normalize the experiences that in the past have created a sense of shame and isolation, leading to increased self-acceptance.
  • To allow the young adults to experience establishing and reinforcing group norms, through direct feedback and, if necessary, consequences. This provides an approximation of how the “real world” deals with infractions of social rules.
  • To provide an opportunity to be praised and rewarded for progress and achievements, thus leading to increased self-esteem. A corollary principle here is that participants begin to see their strengths and talents – and what is possible for them to accomplish with their lives.
  • To provide Rick Silver with a forum for exceedingly bad jokes that, nevertheless, help establish a strong bond among group members. Humor heals.

Life Skills Group / Community Volunteer Corp
Duration: 1½ hours several times per week (depending on the group size and the needs of the participant)

This group provides the opportunity to review and reward progress on treatment goals that were set up in the executive function coaching sessions; and to practice practical life skills such as financial management and how to plan and follow-though on activities. In addition, Young Adult Kids (YAKs) engage in the Community Volunteer Corp, in which participation in several volunteer programs reinforces the ideas that teamwork is critical and that accountability is a vital part of a community.

Core (Emotional Support) Group
Duration: 1½ hours weekly (depending on the group size)

This group is the forum for improving emotional self-awareness, emotional self-control, communications skills, assertiveness skills and practicing healthy, mutually respectful relationships.

Mindfulness / Emotional Self-Regulation Group
Duration
: One hour weekly

Although emotional self-regulation is practiced throughout all Heron’s Gate activities, this weekly group provides the participants with a 30 minute session dedicated to meditative and grounding techniques. These skills are essential for the young adult to acquire if they are to achieve the long-term, sustained emotional stability that forms the foundation for independent living.

Outdoor Adventure Challenge / Team Building Group
Duration: One weekend day per month, with two overnights

This group uses the outdoors as a setting for challenging the young adults’ physical and mental abilities, including safety and problem solving issues; and helps create the sense of team so necessary to the success of the program. Outings include orienteering, canoeing, technical rock climbing, caving, hiking and camping, elementary rescue techniques, and wilderness survival skills.

The Outdoor Adventure Challenge is conducted by Team Link: Shenandoah Mountain Guides, professionals in team building and helping people to relate their outdoor experiences to personal growth.

Exercise Group
Duration: One weekend day per month

This group builds on the outdoor skills from the Outdoor Adventure group and provides an additional fitness component for participants.

Parents’ Support Group

Duration: 1½ hours monthly

This group combines a support group format where parents explore the emotional issues associated with transitioning a failure to launch child to independence; with a workshop format where parents learn and practice specific executive function skills that can be applied at home with their own young adult.

Individual Therapy And Family Services

Individual Therapy
Duration
: One hour every other week

The young adults meet with one of the Heron’s Gate therapists to explore issues related to self-esteem, motivation, trauma, communications and identity.

Family Therapy
Duration: One hour every other week

The young adult, the parents and at times other family members meet with a Heron’s Gate family therapist to explore and resolve communications and emotional patterns that have contributed to the current problems with the young adult and the family.

Medication Management
Duration: One half-hour monthly

Medication management provides an opportunity to review medication treatment effects and side effects, and to adjust the medication regimen as necessary.

Young Adult Executive Function Coaching
Duration: ½ hour every week

Heron’s Gate Executive Function (EF) coaches provide “rubber meets the road” coaching to help the young adults build skills in time management, planning and follow through on activities related to academics, employment and finances. In addition, the coaches work to set very specific weekly and monthly goals, using a Passport book as a tracking system and establishing clear incentives and outcomes regarding performance on expected behaviors.

Parent Support Group
Duration: Two hours every month

The Executive Function coaches meet with the parents and the young adult to review the young adult’s Executive Function goals, and to help the parents establish specific goals for their own behavior in supporting their young adult. Since parents often struggle with setting and maintaining appropriate limits with their young adults, this work might include setting up behavioral systems: behavioral expectations for the young adult which push their current non-functional behaviors using strong consequences and rewards administered by the parents.

Program Review Meeting
Duration: One hour every three to four months

Rick Silver meets with the young adult and parents to review treatment progress and to advise parents how to modify their consequence/ reward systems as appropriate. This is an excellent opportunity for the family to voice any concerns and to problem solve issues that have arisen in both the clinical and logistical aspects of the program.

For more information about the Heron's Gate program for young adults struggling to launch, contact THRIVE at 410-740-3240 or by e-mail.