Will's Choice

by Gail Griffith

  Again, the burden is on parents to ferret out the skilled and well trained from the unqualified—and you are forced to do so at a particularly stressful time in the family, when everything seems broken. But you are not without recourse—or rights: Insist on seeing the educational credentials of the program’s staff and/or any published articles they may have written. Ask to speak to parents of children who have graduated from the program. You are about to make a huge investment in the future well-being of your child; it is not without risks, but you do not have to take the unnecessary ones. And finally, look for empathy and compassion in the people who run the program.*

  “We have had moments deeply filled with anguish and worry,” Rosemary McKinnon told Education Week. “This is such a tremendous responsibility. These parents are entrusting you with the most precious thing they have.”4 So true. And her attitude reflects the degree of engagement and caring a parent should expect from a therapist and a therapeutic institution.

  Bob and I saw all we needed to see at Lost Horizon Ranch. We were impressed. “Would it be helpful if we were to bring Will out for an interview before you decide to admit him so he could get a sense of the place and you could get to know him a bit?” I asked Rosemary.

  “Oh, no,” she replied. “It doesn’t really serve any purpose to expose a child to this setting before they arrive. No self-respecting teen is going to be delighted at the prospect of coming here.” Sound advice.

  How did our lives end up at the end of that dirt road, on a ranch for sixty troubled teenagers? The scenario most definitely stretched the boundaries of my imagination. But what we saw there was heartening—a gifted and compassionate staff dedicated to working with kids in a healing, albeit remote, setting.

  The working ranch offered no television, e-mail, or video games; music and movies were limited to “acceptable” genres. No provocative clothing for girls, no “gang” attire for boys. Pierced earrings and navel and nipple rings needed to be left behind, and profane and vulgar language was punishable by an immediate round of push-ups.

  The kids rose at 7:30 AM, completed chores around the dorm, and after breakfast attended an individually tailored schedule of classes in the converted barn. Afternoons were devoted to individual therapy, group therapy, “experiential” classes in cooking, gardening, or woodworking, and sports. Following dinner, kids could mingle in the common areas before returning to their dorms for reading and reflection before lights out at 10:30 PM. Frequent outings—hiking, camping, skiing, ice-skating, fishing, rafting—allowed the students and staff to take advantage of the extraordinary natural wonders Montana offered.

  I realize that these offerings do not necessarily hold any fascination for teenagers, but as an adult, I would trade a vacation on a Caribbean island to be able to fold myself into the safe, unfettered, structured routine Montana Academy provided. (Lights out at ten-thirty? Every moment of the day predetermined? Individual therapy? Time set aside for exercise and the outdoors? Someone else cooking hearty meals? Friends gathering to chat in the evenings in front of a giant fireplace? Are you kidding?! Add a nice bottle of red wine and bittersweet chocolate bars after dinner and I would be there in a heartbeat.)

  Contact with friends and family was limited. For the eight weeks, Bob and I would only be able to talk to Will by phone once every other week, in the presence of his psychiatrist. Our first visit would follow his initial eight-week session. The program’s academic track provided an accredited high school curriculum, leading to a diploma certified by the State of Montana. It offered a well-crafted curriculum, designed to integrate academics with the practical knowledge the students gained during the “experientials”—a class on physics would be conducted in conjunction with woodshop for a whimsical assignment: “After accidentally tipping over a cow, design and build an implement suitable for righting the animal.”

  Kids were supervised twenty-four hours a day, but there was no “lockdown.” Will would receive intensive cognitive behavioral therapy, one-on-one psychiatric care to oversee his medication, and he would engage in a full sports program. And Montana Academy was coed; we could honor Will’s only request: that he not be in an all-boys program.

  After touring the rest of the campus, we said our good-byes to Rosemary and headed back to Kalispell for our final interview with John McKinnon. I took a final look around as we lingered by the animal pen near our parked rental car.

  “What are those odd animals?” I pointed to the bizarre-looking creatures that caught our eye when we arrived. “Elk,” Rosemary replied matter-of-factly.

  The ranch also hosted chickens, cows, and horses. Students participated in the caring and feeding of the animals, as well as the communal chores, including cooking, gardening, and repairs around the property.

  “Whoa! This is going to be a different experience for Will,” I thought.

  We hardly thought of ourselves as an “outdoors” family; we were city people. I couldn’t fathom Will being enchanted at the outset by the elk grazing on the baseball diamond—or by a program that included wilderness hiking and camping, not to mention extremely harsh winters.

  How ironic, given his terrifying hallucination about “bears downstairs” the morning of his suicide attempt, that we hoped to enroll him in a residential treatment program that offered an early primer on “defending yourself against encounters with bears” and outfitted all of the kids with a set of “bear bells.”

  Our final meeting of the trip took place in a neat one-story bungalow, the administrative office of Montana Academy, located just off Kalispell’s main drag. We discerned from our conversation with Rosemary and John Santa that Montana Academy gave as much weight to the personalities, comportment, and attitudes of the parents as it did the profiles and case histories of the children when deciding which teens to admit. The philosophy suited their therapeutic practice: in order to achieve maximum benefit for the kids, the school had to be able to work with the parents. Hoping to secure Will’s admission, I was anxious to “pass muster” with Dr. John McKinnon.

  He strode out of his office and greeted us warmly. An imposing figure, well spoken and attentive, he put us at ease within the first few minutes. I am sure the folks back at the ranch briefed him prior to our arrival, but I was surprised he was attuned to the details of our case.

  Five minutes into our interview, he probed gently, “So, who found Will the morning of his suicide attempt?”

  “I did.” Again, I looked down at my torn fingernails and shredded a balled-up Kleenex, trying not to give way to tears.

  He paused for a moment, then offered quietly, “God, it must have been horrible for you.”

  For the second time that day, I felt a surge of relief, as if an invisible agent had extracted my heart from my chest and said, “Here, let me take care of that battered artifact for a moment. Let me hold it while you put yourself back together.”

  In the six weeks since Will’s suicide attempt, no one had come close to uttering consolation that touched me where it hurt most. I am sure many people thought it—“God, it must have been terrible for her to find him that morning.” But no one had articulated it until now. Someone had just thrown me a lifeline of sympathetic understanding and I was eager to grab hold.

  His words hung in the air for several seconds like dust particles in sunlight. “Yes. It was terrible,” I thought. I could finally acknowledge it. “How did it feel?” “Yes, dammit, it was the worst thing that ever happened to me.” “It was ghastly” “it was horrific” “it was shocking to the point of nausea.” I didn’t have to utter these sentiments aloud. I acknowledged his words of condolence with a silent nod of assent.

  On Montana Academy’s Web site, McKinnon reflects,

  Few challenges have ever so fully engaged my imagination or ambition or willingness to work. This, too, has been a lucky thing…I like the school’s students and parents and our staff. I have, at moments, lost my temper, but never have enrolled a student I couldn’t like and care about. Nor do we choose
students whose parents we don’t like.5

  That says it all, in my book. These people were honest, decent, and caring and put their best efforts into rethreading a loom of tangled relationships between children and parents—and between children and the wider world.

  If they would have us, we wanted in. We spoke to Rosemary late in the day: it was a match. Montana Academy accepted Will, and they accepted our family. We were giddy with relief. For the first time in six weeks we were no longer in free fall. We had a plan. Everyone understood that Will posed a significant suicide risk—more so than most of the student population in the program. But they were willing to accept the risk and so were we. Bob and I left Montana feeling confident he would be safe in their care.

  I was going to miss Will immeasurably, and worry is not a substance one turns off like water from a spigot, but we believed it was crucial to Will’s recovery that he be in a rigorous treatment setting with other depressed teens. Up to now the sum total of his inpatient therapeutic experience had consisted of two separate hospital stays at the Psychiatric Institute of Washington, one a week long prior to his suicide attempt, and the second a three-week stay immediately following his suicide attempt. Both times he had been placed on a unit for persons with “mood disorders,” none of whom was near his age. In fact, most of the patients on that unit were several years older and represented the full spectrum of mental illnesses. His ability to fit in and find common ground in that setting was a challenge. I was convinced that if he were in a setting with other teens, kids his own age, he would realize that he was not alone in his depression. Even though the issues and disorders that brought students to Montana Academy were as varied as you would find in any therapeutic setting, the tribal bond adolescents develop with their peers might bring Will to common ground. His family had not been able to keep him safe, even under our watchful care, backstopped by consistent and skillful professional help. It was time to take a different tack and embark on an all-encompassing plan.

  Montana Academy was going to cost us nearly five thousand dollars a month. No insurance company on earth offered reimbursement for this kind of residential treatment program for teens. The fees, tuition, and room and board were standard for the kind of program Montana Academy offered, but on top of these costs, we had to calculate the “extras”: frequent travel back and forth from Montana, additional costs for medication and individual therapy. Bob was prepared to draw down all of the savings he had put aside for the boys’ college education to make this work.

  When it came time to move him to Montana a few days later, Will did not put up a fight. After a brief visit with Max, Melissa, and friends in San Francisco, Will and Bob flew to Kalispell on April 29 and spent the day shopping for gear Will needed for school (insulated winter boots, polypropylene long underwear, wool hiking socks, sleeping bag, backpack, Gore-Tex pants, and a headlamp for night hiking). The two of them arrived at Lost Horizon Ranch on the last day in April. Will began school the next day.

  My heart ached for Will, but for the first time in months, in those days in early May, I slept, we all slept, like dead people.

  Dr. John McKinnon’s missive to new parents:

  A Letter to Parents: At the Start

  Dear Parents,

  I want to write this note to you, early in our work together, because I know that enrollment of a child at a therapeutic school can be stressful. I want you to know that we understand this. Perhaps, like other parents, you feel relief to have taken action against a sea of troubles, but it would be unusual if you didn’t have strong feelings about it. Even now, as you drive back over the ridge or read this note at home, you may feel the car is somehow hollow, the house too quiet. You may suffer from regrets. And I know there’s a grief in this.

  Meanwhile, back at the ranch, our new student will now have just begun to absorb the message your action communicates. For some students, parental action spells relief. For others, too immature to see the part they have played, there is only an angry sense of injustice. It’s likely that, in the midst of all the failure and frustration, your child would prefer, on the whole, that you feel ashamed.

  This being so, it may help if I anticipate with you the kind of adolescent rhetoric that you may hear. There must be an infinite number of ways to put you into conflict. But here are some of the familiar leitmotifs:

  “Mom, I don’t need to be here—a little counseling, and all will be well!”

  “I am righteously baffled about what minor flaw of mine could possibly make sense of this parental idiocy.”

  “I didn’t realize you were serious, but hey, now I get it, so I promise—I’ll sign in blood!—if you’ll just take me home I’ll behave now.”

  “Daddy, the boys are crazy, the girls are suicidal—so if you leave me here with these weirdos, I’ll get worse.”

  “Take me home now, Dad, or I’ll never visit your nursing home!”

  Some of you may be spared this deft rhetoric, but most parents hear some variation on these themes, which may make you feel worse, or worry your child is the only one who talks like this.

  Check out with your child’s therapist or team leader any complaint of staff misbehavior that upsets you…We’ll want to know about, and address, any legitimate problems; and we can clear up distortions—our staff will tell you the truth as best they know it and investigate problems they don’t already know about.

  Separation may turn out to be as hard for you as it is for your child—maybe harder. Rosemary and I have all three of our daughters gone from home, as I write, and we’ve learned how hard this is. It helps to have contact, I think. Our staff will bring you news, in regular phone calls, and tell you, from an adult point of view, how your child is doing. Regular phone calls with your child help, of course, though too many calls, and too much news and gossip from home makes it harder to settle into the social world of the ranch. I suggest you make it plain you will reply promptly to every letter you get, but won’t keep writing in a vacuum. This will encourage reciprocation, and may help bring you the contact you need.

  For some parents, anxiety over separation, or guilt and shame about the events that preceded enrollment, are sufficiently painful and persistent that it’s helpful to find a competent therapist to help think these matters through. Take care of yourselves. Our staff needs to concentrate on your child’s adjustment at this point, so if you feel you’re having trouble and want to talk this over, please feel free to call me.

  Finally, I suggest you back off. Let your son settle into school, make friends, struggle with the new discipline, adjust to Thomas’ cooking and learn to do the chores. Let your daughter make her own way. I know this is hard for sad parents to do. Children do bruise one another as they become acquainted; the school’s rules and limits will be resented. It’s likely all of this will be difficult and may provoke worries and suffering and complaints about life’s unfairness. You may well hear recurrent expressions of the wish for a magical, immediate solution, for relief from the hard work.

  But you should know that Montana Academy’s staff and student community tends to be affectionate and attentive. We all should anticipate that it takes time for teenagers to do what you have sent your child here to do. We know this, and we also know that your child may not manage this gracefully, at first.

  From now on, I ask that you speak very directly to your child’s therapist about any and all of your communications with your child. This is the time, now, to build a trusting working alliance. You (and we, and your child) need this. Please tell us (e-mail may be best) how we can help you. You have honored us with the responsibility to care for your child. We look forward to working with you.

  Warm regards,

  John A. McKinnon, M.D.

  Medical Director and

  Program Director

  “Well…that’s quite some missive,” I judged as I read and reread Dr. McKinnon’s letter to new parents from the safe distance of home in Washington, D.C. “I’m sure we won’t see much of that oppositional s
tuff with Will.” Will’s polite compliance was famous. It bordered on passivity. I figured the bulk of McKinnon’s advisory was really directed at other parents, other kids. Wrong again.

  To say that Will’s early reactions to the program, and to his teachers, doctors, and therapists, were less than enthusiastic is an understatement. He met a few kids he liked; in fact, on his first day at Montana Academy he discovered a friend whom he had known before, Marla, a girl who attended his parochial school in San Francisco during eighth grade. What an extraordinary coincidence. But overall, he thought the program was a gigantic waste of time. We had hoped it would be otherwise.

  My first letter to Will at Montana Academy:

  May 3, 2001

  Willo, my beloved,

  By now—week one—you are settled in, wearing full cowboy regalia and wondering why you ever breathed anything but the pure air of Montana. Right? And what about those elk? Wacky, aren’t they? Tell me that you’ve fallen in love with ranch animals.

  In reality, by now, you’re probably feeling pretty funky—homesick and funky. But I’m hoping you’ve made some friends (You’re so expert at that.) and that you’ve been shooting some hoops, and that they can really bake a nice pie at Montana Academy and that your first night in the bunk was a restful one.

  I checked the weather this morning in Kalispell and it appears that it’s warming up and that the sun may be out by the end of the day. When do you get to experiment with all of your new outdoors gear? Dad said that you got a really cool new pair of hiking boots. John would be jealous. In fact, I’m not going to tell him, because he’d make us buy some for him, just so as to be fair.