The clinical model of Onward Transitions (OT) forges a “middle space” for participants (referred to as members), integrating therapy with structure, community, and social events while building lasting relationships.

Milieu means “middle place” in French. OT takes it to mean the social environment that people engage in, where something occurs or develops. OT members’ middle place is both in their therapeutic milieu and in the experiential milieu of the rest of the world. It is this dual existence that helps them to develop the skills they need for greater success in their lives. Where a controlled group can be a safe container for people living with acute symptoms, those with more moderate chronic and episodic symptoms have likely already proven they can do well in that same container. Thus a controlled environment will inherently impact an emerging adult’s development by literally limiting and managing their life experiences with rules that govern group living. Where a control limits something, a structure, carefully plans, organizes, and connects elements to form a greater whole. OT carefully crafts and cultivates a structured environment for its members to experience life, not a controlled one that would remove them from it. 

The structure at OT promotes an enriching culture through regularly scheduled meals, group work, coaching sessions, and individual therapy while still allowing time for people to socialize and decompress. Emerging adults seek a community of like-minded peers living with some of the same developmental and mental health challenges they are navigating, while still having the ability to separate for the group to synthesize in their own space the experiential learning that comes from being social. The social responsibility of showing up for these cultural norms as well as their jobs and classes in the world intrinsically trains members to attend to their commitments in lasting, adult ways.

Families want their children to be connected to a peer group that makes them feel happy, healthy, productive, and forward-moving. Emerging adults in the post-pandemic world know how hard it is to find community. Many grew up in curated and controlled social environments that provided some of this for them (i.e. play dates, extracurricular activities, private and boarding schools, and even suitemates in college) and now struggle to create this for themselves in the adult world. This can temporarily help an emerging adult feel less alone. They can simultaneously feel overwhelmed by being around the same group every day, and supervised 24-7 by professional staff they begin to see as power brokers. For some, this controlled environment not only serves to perpetuate the canned social experience that creates their current social engagement deficits but also continues the message that the “grown-ups” have to manage this for them. 

Once a month OT members formally discuss plans for social events they want to engage in with the staff. In the past year, members have selected to go to theme parks, host a lobster bake, go apple picking, sail on a schooner in Casco Bay, take a ferry to a coastal island, have dinners out, plan picnics, sea kayak, rock climb and explore local beach parks and natural areas. Every Thursday, members select a restaurant (Portland, Maine is rich with them) to have dinner with staff which is sponsored by OT. It is not uncommon for OT members to connect on their own for hitting the gym, game nights, karaoke, trivia, indoor climbing, farmers markets, birthday celebrations, shopping trading furniture, checking in on someone’s pet while they are away, and going to beaches, and concerts. 

The milieu time that OT members spend together at the Pine House and in hosted events helps them to cultivate healthy interpersonal relationships and make informed decisions about who they want to connect with outside of OT programming hours. Part of OT’s work with members centers on helping them plan and implement “adult playdates,” first with each other and later with the community at large. The most significant return on these efforts is the phenomenon of members providing healthy, emotional support to each other outside programming and after hours. About a third of OT members continue to live in Portland, ME long after their time with OT comes to a successful conclusion. 

OT members are: 

• Kind, accepting, and affirming
• Bright neurotypical and neurodivergent emerging adults
• All genders, between 18-29+
• Living with mild to moderate and sometimes chronic anxiety, depression, and executive functioning challenges. 

OT members are not/do not:

• Live with primary substance abuse diagnoses which required a recovery program or monitored sober living environment
• Unwilling or unable to keep themselves safe in Portland
• Experiencing acute primary health issues or self-harming behavior
• Experiencing active eating disorders

For more information, email tracy@onwardtransitions.com.

About Outward Transitions

Onward Transitions in S. Portland, Maine, just two hours north of Boston, is a small, independent, owner-operated program for up to 18 bright, motivated, emerging adults learning to live on their own. OT supports actual, sustainable independent living, helping emerging adults become more autonomous. Participants (members) ages 18-30 never live with us; they live in their apartments throughout the city, selected according to personal preferences and resources. Our clinical and coaching teams (staff to student ratio is 1:2) support them with structure and accountability while working towards the goals members have established using Acceptance and Commitment Therapy (ACT). Unlike living in program housing or living with a roommate, members experience real-life accountability.