Living Well Transitions is a program for young adults ages 18 and above that is rather unique in that except for the offices used for therapeutic activities and homework, computer access, etc., there are no facilities, not even a formal structure as we find in most programs. What Living Well does provide is an experienced support staff that has great flexibility developing healing relationships with the young people who are enrolled.

I had the chance to interview two young men while I was there who had been enrolled for some time. From their appearance, mannerisms, perspectives and intervention history, they showed every indication they would have been very difficult to work with. Actually, if I had met them as clients for the purpose of recommending a placement, my first thought would have been to find a tightly structured school or program with considerable clinical expertise. In reality, both had already been in programs like that without success. It seemed they both were so set on independence that they had fought the programs every step of the way, while still realizing that they were making things worse for themselves by gaming the system. The first thing one of the young men said to me was "Living Well is much better than a residential program."

What Living Well therapists were doing with these two young men was working with that extreme independence feeling rather than what is typical of most residential programs by trying overcome that extreme independence. The heart of the program is for staff to build a trusting relationship with each client, and provide processing help when needed. The staff insists their success comes from meeting the clients where they are emotionally and in their life style, instead of setting up a tight structure for them to conform to as the first step many other programs do.

Living Well clients must be involved in either school or work which can include high school level schooling. As a result, some of the clients might have been having trouble in a Boulder area school or in trying to find employment and enrolled in Living Well for help. Others from elsewhere in the country found Living Well first, and then enrolled in a local school or sought employment so they would be eligible for Living Well services. Either way, the clients live in apartments scattered around Boulder, which they and their families are responsible for. Staff ensures the living situations, housing and neighborhoods are appropriate. In addition, they help the clients make sure all needs are covered, such as liaising with apartment managers before the client commits, getting utilities set up, etc.

Processing life's decisions is at the heart of what the staff does. Staff has daily contact with each client at first. The program is non-punitive, but assertive. When a client has a decision to make, the staff is there to help them think things through, making suggestions and pointing out probable consequences from the different possible choices. The staff has considerable flexibility and needs to be very creative in suggesting ways to handle situations. Suggestions evolve out of the perspectives and experiences of the client, and are aimed toward helping the client build a more healthy way of life. As trust develops in the relationship, the clients learn to listen. When the client makes a poor decision, the therapist takes that as a learning opportunity to help the client grasp life skills in learning consequences from their actions. The therapist is always giving practical and coherent reasons why some choices are better than others.

Using insight based techniques, the therapists start with reminding the clients that they have great potential, and all suggestions are designed to help the client internalize self-respect. As time goes on and a client learns more healthy ways of living, he or she gradually evolves out of the program. Therapists go from daily contact with the client to occasional contact to simply being on call when a client runs into an especially thorny situation.

At the time I visited, Living Well had 14 clients enrolled with the oldest being 26 years old. Eight were in full daily contact with staff, and the others were in occasional contact. Most had had previous experience with residential programs, often with minimal success. The therapists can work with clients with a number of psychiatric issues including high functioning Asperger's, but not those with violent tendencies or uncontrolled serious psychosis. Due to the type of clients they have, group processes are voluntary, group being offered for those who are interested. The main focus is the individual work between the therapist and the client.

My impression of this program is that it might be ideally suited for young adults who need intervention but something internally stops them from conforming to structure. In other words, young people needing help but are "allergic" to structure might accept the light but assertive touch of Living Well. Other clients who just need help getting launched as successful adults could also find Living Well Transitions helpful.