As several of my girls approach their graduation dates, I am noticing a consistent trend. I notice that many of their behaviors were at a more desirable level a couple of months ago then they are today. This goes against the perfect positive correlation between length of stay and behavior extinction that I and undoubtedly their parents would hope to see. That is, ideally, one would hope that the longer one’s child is in treatment, the fewer the behaviors that brought them to treatment would be seen until they are eventually gone forever never to be dealt with again.
The more realistic pattern that I am observing looks more like an ocean, with the peak of the wave being the most troublesome behaviors that were observed just prior to admission followed by the trough of the wave (honeymoon period/adjustment to the program), followed by some returning behaviors but perhaps not to the same height that they were prior to admission and another trough (the repair work that gets us through those resurfacing behaviors) and a sequence of other smaller, more manageable behaviors that ascend and descend.
As I attempt to place myself in the position of the parent anxiously anticipating the return of my daughter, I imagine that I would interpret some of these returning behaviors to be warning flags and signals that my daughter is not ready to return home. As the adolescent in treatment, I would probably question my readiness as well (though, I would never admit this to anyone so as not to risk an extension in stay). As a therapist, it is my job to highlight the overall changes that have occurred over the course of treatment and offer the comparison of current behavioral challenges to the behavioral challenges which were present upon admission. I do believe that the difference in manageability is due to the many skills and shifts in thinking that the girls have utilized over the course of their stay and that those two things will be invaluable in helping them to navigate through their lifelong journeys.