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Essays

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Posted: Jan 6, 2011 08:11

WHY SOME STUDENTS HAVE TO GO

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by John A. McKinnon, MD,
Co-CEO
Montana Academy
Marion, MT
406-858-2339 x230
john.mckinnon@gmail.com

[We reprint here an essay from the series, Letters from Lost Prairie, with permission from the author. Recently it was sent to all parents of current students at the residential boarding school, Montana Academy. We thought readers of The Woodbury Reports might find it useful.-Lon Woodbury.]

Montana Academy recently expelled two students: one sent "back to wilderness" in early November from one team; and a second, at Thanksgiving, from another. The parents of these students know why, of course, but other parents may wonder when they hear this news from a son or daughter. And so, as I inform these particular parents about what happened, within the proper bounds of clinical tact, I will also go beyond those specific decisions to think out loud with you, with all [MA] parents, about this unhappy, taboo topic: a student's expulsion.

For a start, we hate to expel students, but sometimes have to do it. We always do so reluctantly, and relatively rarely. Because we know we disappoint anguished parents, and because we ourselves feel that we have failed, we probably err on the side of patience and wishful thinking, particularly if the reasons are iffy. Our reluctance is not always a good thing. We sometimes have dallied and wasted a family's time and tuition. Such delays also affect others. A team is an intimate, interdependent sorority or fraternity, and the ranch and Sky House communities are close. No man, and no student, is an island. It is never only one student and family who are affected. A treatment impasse, a student's disruptive misbehavior or dangerous actions, can put others in jeopardy, directly or by contagion, increasing costs and risks for other families.

An expulsion suggests an admissions miscalculation. We worry about these potential debacles during every admission screening. Yet we also know that a surgeon who never has a bad outcome fails to make use of his full capacities. Never to fail is to withhold a help that, often enough, could make all the difference. Nor are we omniscient. Provided histories are imperfect. We do our due diligence, as you all know, prior to making enrollment decisions, but, as someone fatuously remarked, there may still be unknown unknowns.

From time to time, then, parents choose MA and we enroll a son or daughter who later, for various reasons, cannot be allowed to go on. Those reasons start with safety-e.g., risks of suicide; serious self-harm; assault; run-away; contraband drugs or weapons; gross insubordination; psychosis; sexual predation; promiscuity; or anorexia. Because MA's campuses are unlocked, and supervision relatively relaxed, these are exclusionary criteria at admission and also reasons for expulsion. Moreover, these criteria help define the MA culture for all students who become members. All students and parents soon learn that, if certain lines get crossed, a student cannot stay.

Treatment failure is another reason. Occasionally we must conclude, despite our good intentions and initial calculations, beyond all reasonable patience, that MA's program is the "wrong" program, because it does not provide what a particular student or family turns out to need. In this situation there is no need for an acute departure, but also no good reason to go on and on, if the likely prospect is only a continued demoralizing failure and no chance a legitimate graduation. In psychiatry, if not in nation-building, failure is not a valid reason to keep on doing what isn't working.

Expulsion sometimes is a therapeutic intervention, I should add. That is, expulsion may be just the next logical step, even if it feels like a detour, in a protracted, auspicious journey. Over the years we have sent students "to wilderness" with the explicit offer that, if (s)he makes good use of the experience and "processes" this failure constructively, we may allow that student back to finish the program. We offer a hope, never a promise, and of course we may later decide, or parents may well decide, that there may be a better fit elsewhere. Yet over the years some students have been sent away and have come back, chastened and ready to try again, and have successfully completed the program. For some, in short, to be expelled can be au revoir, not good-bye. Two students presently at the ranch have made this detour successfully, long ago, and are now back on track.

Recently, as I say, we sent two students back to wilderness. The occasion for one was a treatment impasse and premeditated run-away that had our worried staff chasing down windy back roads and shouting into the gelid forest. In pitch darkness, cold and scared, he allowed staff to pick him up-and we sent him back to wilderness. The occasion for the other student's departure also was a treatment impasse. For weeks she refused to engage in her own therapy or the program, bullied her vulnerable team-mates, subverted therapy by throwing confidential information back at team-mates outside of groups, and (the final straw) made nasty threats to do a team-mate harm in her sleep, and so had to be removed from her bedroom. In both these cases a careful history makes clinical sense of this misbehavior, but those histories properly lie beyond the scope of a letter like this.

This leaves one final issue to discuss: the impact of an expulsion upon a team and the larger community. I hinted at this issue by suggesting that one student's progress (or lack thereof) may influence the prospects for other students and families. The point is: that a student who resists participation, disrupts class-rooms, holds teachers in contempt, sows division on a team or instills fear in a dorm bedroom, or undermines adult authority, or bullies gentler students, or subverts the trust that makes it safe to speak the truth or talk frankly about grief, pain or trauma, or invites others to collude against adults in sneaky illicit acts-is not just misbehaving, but attacks the very fabric of a culture that makes the Academy's clinical work effective. The adults of the community had better not let such subversive misbehavior go on for long. It is upsetting to fellow students when their polite remonstrance's, even their confrontations, fail to change a fellow student's destructive behavior, but it is profoundly demoralizing and frightening to live in a community where an aggressive student's bullying is permitted, where it is no longer safe to speak honestly, and where the adults seem also to be helpless to put things right. The whole therapeutic enterprise is at stake when this basic trust is under attack-and this constructive culture is what an expulsion, at the limit, is meant to protect.
When I myself arrange for a student to leave under a cloud, I might add, I do it without forewarning and in the early morning, so as to make it safe and to avoid a soap opera. For a student who leaves for most of these reasons has not earned a dignified, emotional send-off. The salutary message to all wants to be clear and grim, without sentimentality.

Young people cannot always say directly what they need, but they corroborate the rightness (or wrongness) of adult interventions in team and community meetings. On Monday and Tuesday this past week the Student Council helped the Ops team organize a series of community meetings. On Tuesday there was a remarkable pulling together. For an hour students rose to say how much they cared about a community in which they felt respected and enjoyed friendships they had never had before, where they did not need to be defensive or put on an act. Neither of the expelled students came up directly. There was no outcry or protest, no sullen holding back, not even an expression of sadness.

Instead I sensed the meaning of their departures in a community in which it now felt safe enough for expressions of trust and mutual affection. To hear young people speak this way in a crowd of a hundred teenagers and adults is rare and magical. No doubt the magic resulted from difficult months of integrating the new and older members, and no doubt the coming December graduation, and new students in January, will for a time break the spell. But it was a remarkable meeting. A number of students even used what (when I spoke) I called the "L-word"-speaking directly of their love for one another, and for their favorite staff, and for "this place."

On last Monday, in the company of their team-leader, who was up with me in the night, and again on Wednesday and Friday when I led the team group, myself, in the absence of their much-loved therapist, who was stranded in a snow-bound airport, the girls asked about their missing team-mate. They talked about waking in the night to realize that a team-mate was being sent away. They asked about my decision. I invited them to say frankly whether they objected or thought I had been mistaken. None said so. They were somber and sad about her failures and about her having to go. Some recalled what they liked about her, and confessed that they had been alarmed by the noise and loud talk that woke them in the night. They wished her well, and, if she got it together, they hoped she might come back.

And then they calmly turned to other matters.

Montana Academy is a coeducational therapeutic boarding school for struggling teens specializing in both treatment and education.


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