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

 

Heron's Gate: How And Why It Works

The Heron’s Gate model of care differs from more traditional outpatient approaches to the struggling young adult in many ways.

  • The comprehensiveness of factors addressed – Being “stuck” in the transition to independence is rooted in a complex array of life experiences. Mood and anxiety disorders, substance abuse, trauma, difficult family dynamics, issues of shame and low self-esteem, repeated failures at school and at work, alienation from a healthy peer network, and poor emotional awareness and self-regulation are all addressed by the therapeutic interventions of Heron’s Gate.
  • The focus on a complex web of relationships among the young adult, the parents and the practitioners as the fundamental catalyst for change. Long-term, committed, loving, caring, patient relationships form the psychological bedrock of Heron’s Gate -- healing and growth occur only in the context of these relationships. Foremost among these is the young adult cohort group, which forms the therapeutic backbone of the program. The intense relationships that are created during the many peer group activities helps the young adult build a caring, accepting platform from which to safely launch explorations into self and practice new cognitive, emotional and behavioral skills. As one participant stated, “Our group feels like a tribe.” – a testament to the power of the cohort as a referent for shaping new life patterns. Relationship is the chrysalis that holds the individual as they undertake the difficult work of psychological transformation.
  • The intensity, frequency and duration of program activities – Typically, the family participates in a twelve-month program of individual, family and group interventions for the initial phase of the program, with a follow-up, “stepped down” treatment plan designed to maintain support for increased independence.
  • Setting expectations and exploring readiness for change – Understandably, parents enter Heron’s Gate hoping for relatively rapid resolution of their child’s problems, without a clear understanding of the complex web of psychological and social factors impacting development, or of the time and effort required to reshape these factors into a healthy whole. Prior to and early in Heron’s Gate, multiple meetings with the parents and the young adult help create a more realistic appreciation of the pace of personal transformation and establish specific goals and outcomes to be achieved in the program.
  • A strong systems approach – During the transition to independence, the young adult still requires significant involvement of the parents for the treatment to be effective. This involves the addition of family therapy, a parent support group, parent inclusion in executive function training, and establishing specific behavioral goals and expectations monitored by both the clinical team and the parents.
  • Goal setting and reward/ consequence programs – Parents, young adults and the treatment team establish a tightly coordinated and closely monitored set of goals that define the life skills necessary for the young adult to move towards independence. Frequent communications among the clinicians, parents, young adult and attending staff keep the young adult motivated, active and on target.
  • Availability of “real time” treatment – Since the likelihood of spin out is so high in this population, we have found it necessary to add a component where we track and respond immediately to any urgent or emergent situations that arise with the young adult and their family. For example, a crisis call from the parents in the morning might result in an urgent clinical team meeting later in the day, and perhaps a family meeting to correct the problem in the evening or early the next day.
  • Coordinated, multidisciplinary treatment team approach –Heron’s Gate considers the clinical staff, the young adult and the parents all to be actively engaged members of the treatment team. Tightly coordinated communication allows us to track the progress and problems encountered by the young adult, to make use of therapeutic opportunities as they arise on a daily basis and to adjust the treatment plan frequently as needed. Thiscoordination is achieved through weekly clinical team meetings, a clinical coordinator point person, frequent phone calls and regular emails to the parents, and regularly scheduled meetingswith the family.
  • Increased administrative coordination – Scheduling the complex array of appointments, ensuring attendance at all activities and providing support for billing issues are part of the enhanced customer service that makes Heron’s Gate run more smoothly for the families.

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.