In intensive treatment settings, efforts have necessarily focused upon emotional and behavioral strategies to first, stabilize and reduce destructive patterns and then, to help students develop positive coping skills. To do so, a treatment setting needs to filter out the very elements that were past negative influences, while immediately confronting destructive patterns. In this sheltered world, a student begins to find success. Each time, though, that less structure is offered, a student will struggle, as he or she adjusts to the responsibility of making more and more independent choices.

As the therapeutic world is designed with strong boundaries and structure -precisely because the student could not handle the "real world" experience - the goal of successful treatment is to re-introduce the "real world" in a way that minimizes regression while supporting the students ongoing testing of his or her new "wings."

There are strengths that students have developed that aid transition to college when completing an intensive program. Upon completion, a student will typically have the following strengths upon which to draw:

a. Highly Verbal - these student possess superb expressive skills, they can talk the talk. They can be very persuasive in the college interview process, and should take advantage of such opportunities.

b. Self-Awareness - students know when they are slipping. They have insight into how relationships work and do not work. They understand what situations make them vulnerable and can act to reduce risks.

c. Ethically Centered - these students "see through" the rationalizations and manipulative strategies that others may be more influenced by. They know what is "right," and how to act in a morally responsible way.

d. Strong Parental Support - students usually have a support system, complete with immediate help and insight, to navigate what could otherwise be a lonely and confusing journey. This is in contrast to other students who haven't gone through the deep self-examination and bonding that most families experience in treatment.

e. Can Successfully Navigate Structure - these students have learned to dot the "Is", and cross the "Ts." They can comply with the regulatory challenges of higher education because of the level systems, point systems, feedback forums, etc. found in treatment.

f. Resilience and Optimism - By the sheer effort to be successful in an intense setting, most students acquire a deep belief in their abilities to be successful in challenging situations. They have direct evidence that one can become happier, and one can endure.

Students transitioning from an intensive treatment setting also can find that they have some weaknesses when it comes to successful transitioning to college. Some, or all of the following, can sidetrack a well-intentioned student:

a. Lack of Successful "Real World" Experience - coming from the protective "bubble" of treatment, students have to deal with more "grays" than the obvious black and white of treatment. When do I confront another? How much do I disclose? Now that I don't have to do things, what things are important - how do I prioritize?

b. Past Failures - Memories of old baggage, coupled with trying out new strategies outside of treatment structure, can create great anxiety and self-doubt.

c. Entitlement - Where else but in treatment are so many so vitally interested in your emotional state, your health, your recent insights, your school and social performance? Where else are so many so quick to respond to your needs? Leaving the immediate 24/7 support of treatment can create expectations that just aren't realistic in everyday life, leaving others overburdened, or the student regularly disappointed.

d. Strong Parental Involvement - Just as treatment can create expectations that others will decide and organize your time, as well as provide great support, so can some parents overindulge a transitioning student.

e. Highly Verbal - Students possessing an array of expressive skills are adept at covering up old patterns or diverting the focus of caregivers.

f. Lack of Self-Discipline - Students are unable to self-govern effectively if they have been in a setting that previously made all of the decisions for them.
g. Inflated Sense of Self - As students progress in treatment, much is made of their success. This helps to reinforce change, but also can provide an unrealistic view as to how the world provides acknowledgement.

h. Credit Rich and Knowledge Poor - After being in an intensive treatment setting, some students may come to college with an academic background that includes: Fragmented credits, self-paced learning programs, limited class offerings, and a reduced focus on academics in the interest of emotional and behavioral change. These students are often overwhelmed when starting college. Homework - where one decides what and when to do it - is a new experience.

i. Romanticized View of Future Academic Possibilities -Students who are not in the mainstream of competitive academics are prone to making plans based on variables such as the location or reputation of a school, with little thought as to entrance requirements, course offerings, etc.

The Challenge: Exploiting Strengths While Mitigating Weaknesses

We see four components crucial for a successful transition to college: 1) Students; 2) Parents; 3) Program/School; and 4) College. There is already in place well-formed relationships between students, parents, and the school or treatment program. Taking advantage of these relationships, there can be intentional collaboration to ensure effective transition. As these three entities work together, students can be prepared and supported to choose appropriate campuses. The work of college placement exams, applications, tours, and other tasks must involve each of these entities.

As these tasks are completed, a student needs to develop certain skills that we classify as either hard skills or soft skills. How well a student develops these skills correlates with long-term success in a college setting.

HARD SKILLS:
Going to school is the "easy" part - four hours of classes, then maybe three hours of homework a day. Not bad work if you can get it. The rub, is how to plan the time, how to prioritize the work, and how to break it down into goals and sub-goals, first by the week, then the month, then by semester. In addition to providing a foundation for academic success, planning plays an important role in ensuring a student's successful transition to the "real world."

Students also should understand their academic and intellectual strengths and weaknesses. An ADHD student might try and take classes in the morning. A kinesthetic learner should avoid the large lecture hall format, whereas the auditory learner may be very comfortable in this setting. Students must know what works for their particular learning needs and styles.

Students need an opportunity to practice a range of skills while in intensive settings and during home visits or during the period between discharge and college entrance:

Financial Skills - Students need to acquire skills to learn to balance a checkbook, manage weekly expenses, critically scrutinize a lease, as well as be a discriminating consumer. Credit card scams are a particular threat to incoming freshmen. Opportunities need to be extended to students to practice these skills, if even in mock situations while in treatment.

Navigational Skills - Before entering college, students can benefit from trial runs of finding resources in the community, such as: twelve step groups, therapists, community services and shops, older mentors, sport leagues or hobby groups. Students need to know where the health clinic is, and where and how to drop and add classes. They should know they will typically be more successful sitting in the front of classes. They should know where the dean's office is and how to contact an advisor. Without these skills, students can become over-dependent on others to structure their lives for them, and in so doing set themselves up for failure.

Hygiene and Self-Care Skills - Students must learn to monitor their own health, and handle such things as illness, dental care, medications, laundry, food, and other concerns previously overseen by parents and programs.

Organizational Skills - Although classes and homework will provide structure for part of a young person's life, other elements must also be consciously planned. A student's plan for each week should include focus on grade requirements/tasks, work or volunteering, relationships, fitness and money management. Students who can independently develop a weekly schedule and follow it prior to college entrance tend to be more successful than those who do not.

SOFT SKILLS:
"Soft skills" are much harder to quantify, but they are crucial for a student to develop. These skills include:

Persuasive Skills - Students must learn to self-advocate with professors, roommates, dorm assistants, landlords, etc. Programs and families can support this process by intervening less and becoming less directive in challenging situations as a student acquires skills while in treatment.

Interpretive Skills - Although students from treatment are skilled at assessing potentially troublesome situations, they must learn to rely and trust themselves. This can be difficult to do in a treatment setting where there are so many "experts." Families and programs can begin to take a back seat as students grow in treatment by neither second guessing nor intervening prematurely.

Intuitive Skills - Just as a student needs to assess troublesome situations, there is the need to be a good judge of character. Students coming from treatment often excel in this arena. It can be helpful to emphasize this strength with students as they enter the college environment.

Untouchables

All students transitioning from treatment to college have at least some awareness of their "triggers" or weaknesses when it comes to the risk of relapse back into destructive thoughts and behaviors. It is helpful if students enter into agreements to immediately seek help if they begin to dabble in areas that could include issues such as the following:

• Drug/Alcohol Use
• Promiscuous/Casual Sex
• Stealing/Cheating
• Pattern of Truancy
• Acquisition of a Credit Card

Conclusions

As we have surveyed graduates from the Oakley School over the past five years, we have had the aforementioned suggestions confirmed time and time again by the successes and failures of our students. We note that to this point, our research has been mainly anecdotal. In the coming months, we hope to complete a formal research project to further identify those factors and strategies that can help ensure student success in college settings. Although a program, school or family can do much to prepare a student, when it comes down to it, all the tools a student may acquire are still within his or her power to use. The old adage about horses and water drinking still applies. In our case we hope to at least get them thirsty.

[This is an adaptation of a paper that was presented at a NATSAP Regional Conference on June 25, 2005.]