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A vs B + X = ? How To Decide Which Treatment Program Is The Right Treatment Program

The journey of exploration and investigation of residential therapeutic programs can be a daunting, overwhelming, and taxing – and let’s face it, most people don’t have the luxury of doing this research as a purely academic task.  It is usually a process initiated because the situation at home, or for a loved one, has gotten to the point where complex and sometimes hard  decisions need to be made, thereby infusing what might otherwise be a rational decision with a difficult dose of fear and anxiety.  While these emotions tend to help drive us to action, they can also be misleading ingredients when crafting such a complex decision.


There are many ways to go about the process, and as is the case with most therapeutic processes, the act of engaging in the process is usually the most important element.  While some ways may be more efficient, doing what’s best for you and your loved one is what’s most likely going to be most effective.  If the time has come to act the only way to do it wrong is by not doing it.


Many families choose to employ the supports and services of an Educational Consultant or Referring Professional in order to assist them in this process (more information about these professionals can be found at Therapeutic Experts, and this relationship can bring some much needed experience and expertise to what can otherwise be an overwhelming decision.  The addition of professionalism and objectivity to the list of ingredients in the decision making process is certainly one way to mitigate the long list of unfamiliar variables in the equation.


And yet even with the guidance of a professional, there still comes a time when the parent must choose the placement, and this usually comes down to an A vs B (and sometimes vs C) decision.  With help, and with time, understanding the unique elements of A vs B can actually be made relatively clear.  Consultants and Programs are often able to articulate unique programmatic strengths, differentiating factors, key core elements, and treatment modalities and philosophies, which can assist a family in making an A vs B decision.  


Are you investigating an adventure-based wilderness program, or are you looking for a more contemplative experience with less demands on physical activity?  Are academics primary or secondary considerations?  Do you want a therapist to be well versed in the general approaches of Cognitive Behavioral Therapy (CBT) or do they need to be masters of Dialectical Behavioral Therapy (DBT)?   While this is valuable information, it doesn’t always address the X Factor, in regards to your well-known loved one.  The X Factor is how your loved one will respond to, engage with, and benefit from the supports, services, and interventions that are offered.  


The question is not  “Would you like A vs B?” or even “Is A or B the better program?” – the question is much more complex: “Will A + X (factor) likely result in a better outcome for your loved one and for your family than B + X?”  


When evaluating the A’s vs the B’s, understanding the implications of adding the X Factor becomes the biggest variable in the decision.  How will your loved one respond to a wilderness setting?  Are they a potential flight risk?  If so, then A (geographically isolated) + X is potentially a better option than B (geographically accessible) + X.  It doesn’t mean one model is superior to the other – simply that the X Factor must be evaluated as a part of your unique equation.  For instance, if your loved one is struggling with anxiety or depression then a CBT approach may be just the ticket, although if the X Factor includes a borderline diagnosis, then DBT may become a much more important element, and while CBT may be an excellent therapeutic approach, it may prove to be an insufficient element in your equation.  And so on.


For the purpose of this article, the decisions have been broken down in a reductivist and binary fashion, but people, families, communities, and therapeutic interventions and residential placements are all much more complex than simple 1’s and 0’s.  There is no easy algebra imbedded in the placement algorithm.  Fit, the alignment between a client’s strengths and needs and a program’s supports and services, is an important factor, and the X Factor is, admittedly, much harder to predict.  Unfortunately, nobody in the field of behavioral health has a crystal ball, but through research, and potentially the assistance of an experienced referring professional, families can break down the equation to provide themselves, and their loved ones, with the best chances for success, but only when the X Factor is considered as a primary element in the equation.



About the Author

headshot of Jake WeldJake Weld holds a masters degree in education and has over twenty years of experience in traditional, LD, and therapeutic schools, adolescent and young adult programs, and conventional, wilderness, and residential settings. He has served as the Executive Director of a therapeutic boarding school, the Assistant Headmaster of a specialized LD boarding school, and as the Academic and Program Director of various schools and programs.  He is currently the Director of Admissions and Business Development for Mansfield Hall, a specialized college support program in Burlington, VT, and Madison, WI.