Onward Transitions, an Aftercare Destination
“Couldn’t they just move in with you?” was oftentimes the tongue-in-cheek question we would be asked,” explains Darrell Fraize, Onward Transitions Co-Founder and Chief Clinician, as he describes some of the impetus for Onward Transitions’ model design. “First when young people were finishing up with us in the wilderness, and then in my private practice, the questions and the recommendations would point in the direction of needing a community, or milieu experience where clients could have access to something beyond a set of clinical hours. So, we built a model that was more of a destination than a program,” Fraize continues. “We chose a city that was small, safe, had resources, and an appeal for emerging adults and their families that folks would want to move to and try out their new skills with a whole lot of ‘invisible’ and frankly visible supports in place. This way they could go to college and be in treatment. They could get a job and be in treatment. Most importantly, they could live in their own space, living their own life, and be in treatment,” he adds.
For some emerging adults coming out of primary care, whether it be a wilderness program or residential treatment center (RTC), their progress requires some reality testing beyond a contained environment before they try to live without a significant level of support. “Half of our current membership came to us directly from the wilderness or an RTC, motivated to put change into action and needing a high level of clinical and functional support to achieve this,” adds Co-Founder and Executive Director Tracy Bailey. “They, their families, their clinicians, and their educational consultants were all in agreement that their anxiety, or depression or executive functioning challenges were going to likely be too much for them to manage without a high level of sophisticated support,” she adds. “And so, they chose Portland, Maine as their destination city to reclaim their lives, while working with us.”
As Jesse Viner, MD, CEO and Chief Medical Officer at Yellowbrick in Evanston, IL wrote in 2008¹:
Residential treatment centers continue to function on an outdated asylum model of treatment; Go away to get better. The asylum model of treatment does not offer the concurrent experience and opportunity to build internal strengths and an anchored life in the community while receiving necessary professional support and skilled services. The emerging adult is then at risk for stalled development, misunderstanding, continued suffering as a demoralizing personal failure and experiencing shameful estrangement from needed family and friends.
It was this need that brought the co-founders of Onward Transitions together. Fraize explains. “Tracy, Margie (Lannon, CFO) and I wanted to provide a niche service for folks coming out of treatment and seeking a destination to learn experientially with a big safety net or close tether if you will. We have fifteen different groups during the week, meals, recreational activities, drop-in at two locations, clinical sessions, life coaching meetings and on-call therapeutic services. Tracy and I live in the heart of the city within a mile from all of our current members. Most importantly though, our members have a supportive peer group to bounce ideas and mistakes off of in addition to all of that professional support.” Fraize adds “there are lots of places out there doing incredibly good work with emerging adults. We want to be the place that helps keep that work alive in the real world.”
¹http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.557.5207&rep=rep1&type=pdf