Mental Health Matters

Cultivating Growth in Adolescent Therapy with Barry Fell

Todd Weatherly

Join me as I welcome Barry Fell,  Executive Director of TELOS Adolescent Treatment Center, to uncover the shifting approaches in adolescent behavioral health treatment. Barry shares his vision for how adolescent treatment has moved to embrace clinically sophisticated approaches, emphasizing a delicate balance between setting firm limits and nurturing personal growth.

Barry and I discuss the historical context of behaviorism, reflecting on approaches like Glasser's Reality Therapy, and how essential it is to contextualize these methods within modern treatment frameworks. We share stories that illuminate the challenges faced by both adolescents and staff in adapting to new environments, and the importance of consistency in structure to ensure authentic progress.

Finally, we focus on the transformative power of persistence and innovation in treatment. In the story of student’s journey to mastering the free throw we highlight the how the right challenge with the right guidance can foster transformative and enduring resilience . In our conversation we get to hear stories about renewal and growth that inspire hope and affirm that mental well-being is a journey not a destination.

Speaker 1:

Hello folks and welcome back to Mental Health Matters. On WPBM 1037, the Voice of Asheville, I'm Todd Weatherly, your host therapeutic consultant and behavioral health professional. With me today, out in Utah, is Mr Barry Fell. Barry Fell is Executive Director of TELOS Treatment Center and Therapeutic Boarding School, working primarily with adolescents, but young adults as well, struggling with mental health issues and co-occurring issues. Barry is originally from England, as you'll be able to tell from his accent here in a minute. He moved to the States in 1999 after meeting his wife, brittany in native South Carolina, you know, bringing it home to the Carolinas.

Speaker 1:

Barry started his career in adolescent mental health space in 2000. He worked in direct care at Heritage Schools, one of the original residential treatment programs for teenagers in Provo, utah. After cutting his teeth, as many of us did in direct care, he realized his passion was in the clinical side. After being mentored by a veteran therapist, barry got his MSW from the University of Utah. He started a career in mental health counseling in 2006 with TELOS, which at the time was a new inpatient treatment program serving adolescent males. Barry served as the clinical director at TELOS for eight years and currently serves as the executive director, which he stepped into in 2016. Additionally, barry authored a book, consequential Choices, in 2019,. The premise of the book is to help parents choose the right program for their struggling child, which we'll talk a little bit about.

Speaker 1:

Barry, welcome to the show. Yeah, oh, thanks for having me. Absolutely, I'm excited to be here. Yeah, well, you know I got to go out there and visit campus, which was great when we were doing some Utah program tours and things like that, and I really enjoyed the conversation we had. And you know in your bio I was talking about, you know, cutting your teeth and direct care, which I did as well long ago, back in what, 1994? I was the first job out of college and you know the field has gone first job out of college and, um, you know, we've, you know the.

Speaker 1:

The field has gone through a lot of changes since then and I think that something that and you're not alone I always end up having this conversation with people who started off in the field very early on and part of part of what is not well-received and we call it the old behavior mod, right, part of what was not well-received is some of the methods that were used in behavior mod and setting overly harsh consequences and, frankly, consequences a lot of times that didn't necessarily line up with the behavior which is a key function of that, of that strategy, if you're going to use it. But you know, as time has gone on, lots of more, lots more clinicals gone into the field, we get a lot more sophisticated clinical, theoretical approaches that are part of how we do the work and how we structure the work. But you know, I think what you and I started to started to talk about and started to like how do we do something different? And I think something that you bring into this part of your leadership is let's not throw the baby out with the bathwater, firm limits and giving person goals and having things that they've got to do, including hard things sometimes, and making good choices.

Speaker 1:

Like that part of the work shouldn't get lost. There's a, there's a clinically sophisticated way of doing that and if what you do is you over-accommodate the feelings, you know the, the sensitivities of the person that you're working with, the likelihood is you're not going to move their needle at all. Um, and I, you know I don't know if I, I don't know if I brought that out in the most eloquent way possible, but you, I think part of your book is probably about that, though I have not read it. I will now Tell me a little bit about that, how you see it, as it translates to running a present day clinically sophisticated treatment program there in Utah with Telos there in Utah with T-Lives.

Speaker 2:

Well, this industry, this space, it's still in its infancy.

Speaker 2:

I mean, if you think about other industries and we're contrasting the lifespan of, let's say, this industry versus the traditional medical models of hospitals and what physicians have been doing versus the traditional medical models of hospitals and what physicians have been doing, residential treatment came about in the late 80s, early 90s and we're probably five or six iterations down the road from how it started and, just like any field, it's evolved.

Speaker 2:

And the tragedy about our space currently is it feels very much like we're all being tied by the same brush and we're being tied by a brush from yesteryear Right To your point, tom. Programs have come so far from what they used to be, which were behavioral programs. The word behaviorism I think it's a grossly misunderstood word. I remember in 1999, when I first joined this space at Heritage Schools, I was sat in a training meeting and it was a two-week training course and the first meeting was a session convincing all of these new employees that heritage is everything but behaviorism. And the reason they did that was because behaviorism had been underscored as the thing we need to move away from.

Speaker 1:

That was the first iteration of treatment residential treatment.

Speaker 2:

We're here to contain and control bad behavior and we're here to give consequences which were really just punishments to unruly adolescents. There was no real deep dive into what was driving the behavior.

Speaker 1:

Very adjudicated focused, like you know, very much juvenile justice kind of focus right, yes, yeah, yeah, yeah, it was, it was it.

Speaker 2:

I mean, I can't talk to you now. It's primitive. So I'm sat in this training session and I'm being convinced that behavior is in this ugly thing and we've got to tell the world that we're everything but behavioral. And now I am, you know, 25 years into my career and I look back at that training session and went it was so mismarketed and misunderstood because behaviorism is very much a part of programming. It's very much a part of residential programming. Behaviorism isn't the problem and it never has been the problem. The problem is the intent behind it and the problem is is how behaviorism, behaviorism is deployed. So it's deployed with by a team of neanderthals who are punitive in attitude and who who were not sophisticated in delivering the behavioral approach.

Speaker 1:

You won't be surprised by this, but I was one of the few people. When I my first job with a psych degree versus a criminal justice degree, I was surrounded by people with criminal justice degrees. I was one of the few with a psych degree, different paradigm, yeah.

Speaker 2:

Different paradigm. Yeah, different paradigm. The paradigm today is when you see bad behavior, you're not trying to contain and control it. What you're really doing is asking what is that behavior communicating to me? What messaging is in the behavior? And in order to eradicate the behavior or at least change the maladaptive to adaptive, we need to deep dive into the driver behind it and understand it. And there's actually value in some behaviors because it is a form of communication and if you know how to interpret it, you're going to learn a lot.

Speaker 2:

So I I've you know, I very much believe that a program without behaviorism is pretty much an unruly program, because behaviorism is really about using behaviors as a means to learn, as a means of communication, and it's also about changing maladaptive to adaptive and reinforcing adaptive behaviors. If it stands alone, then it's pretty shallow, but it's a layer of a program. It's not the. It used to be the only layer and it was this thick, right, but programs today are layered, they're far more sophisticated and you do need a behavioral prep can, uh, you do need a behavioral component, that that contains and controls outlandish behaviors and and protects the milieu from outlandish behaviors, but, more importantly, to assess those behaviors and understand what's driving them and then and then create a new strategies, new tools, new skills, right well, because you can't stop behaviors becoming behaviors. It was about making sure that you're adapting maladaptive to adaptive.

Speaker 2:

So yeah, that's a long-winded way of saying. One, this field has adapted to behaviorism isn't such an ugly word. It shouldn't be an ugly word if understood correctly. And three, it's unfortunate that we've been tired. The programs of today have been tired with yesterday's brush. Now are there guilty parties? From yesteryear hell to the yes yes yes, yes there are.

Speaker 2:

They were doing the best they could with the resources they had in the circumstances they were under. It's just that our knowledge and our wisdom expanded exponentially and we realized that's not the way to do things.

Speaker 1:

Let's adapt yeah, and you know it's you did a good job of. I'd like to tease it out a little bit, because you know, if you behave your mind, behavior modification it's like, well, obviously, if you've. You know, if you behavior modification it's like, well, obviously, if you've got someone, especially if you've got an adolescent that's coming to a treatment program, chances are good they've been engaging in some behaviors that no one else out there is willing to tolerate anymore. School won't tolerate it, community won't tolerate it, family and home and parents won't tolerate it, right? So you know, whatever those may be, we want them to be able to engage in an experience where they do some pretty significant work and when they return to that environment, those behaviors are no longer there. They've been replaced by adaptive behaviors, behaviors that allow them to not only coexist with all their peers and partners and family members, but they also can set goals for themselves and proceed and grow and do the things that an adolescent to a young adult, an emerging adult to an adult, we expect to do. Their goals are the same as everybody else's, you know go out, get a job, have a life, have a purpose. Those are the things. But you know, as you were saying, this behavior mod. You know, when it used to be all we had and it was this thick. You know that was the thing it's like. All you need to do is correct these behaviors.

Speaker 1:

And the book they gave me when I came into the field was Glasser's Reality Therapy, and Glasser got into a little trouble. He was talking about, like you know, there's no such thing as mental illness. Either people have adaptive, they have an environment that supports adaptive behaviors, or they're in an environment that supports maladaptive behaviors. If you shift them from an environment that supports maladaptive behaviors, that supports adaptive behaviors, those behaviors will emerge and the maladaptive behaviors will disappear roughly, and it was. You know, reality therapy is a great processing model, but the, you know, and it causes. It causes a child and adolescent to reflect on choices, whether those choices are getting them what they want. Is there a better way to do it? Is there another way to do it? Are they willing to do it this different way? Is it within their power, et cetera, et cetera. Right, but you know the the other thing is is that you start to scratch the surface at what you like, what you're saying, what is the underlying, what is behind this behavior? What is this behavior telling me and every kid's got their own different story right Like maybe it's a traumatic event that happened to them, maybe it's something that they struggle with on the social scale.

Speaker 1:

There are all kinds of things that we have a lot of sophisticated tools for addressing and I and I think that you know, I think that the struggle that we get into in the field and again, guys like you and me, we end up we end up talking about this thing all the time is that you, you get staff, we end up talking about this thing all the time is that you get staff and I think you're doing a great job of because I've gotten to be there and see those folks great job of kind of bringing this home with people. But you'll get staff in the field. These days they're not trained at all in behavior mod. They're not trained really at all in kind of setting these harder limits and being okay with confronting conflict with a client. They've got all these sophisticated tools and theories and everything else and they try getting in there and do sophisticated work before this kid has even looked at what just basic self-reflection is.

Speaker 1:

Is this behavior actually getting you Like they don't have a connection and it's. You know what we're seeing in the field is and that's why I say don't throw the baby out with the bathwater is like you were saying. It's hard to move the needle with someone. You can give them all the sophisticated clinical stuff in the world treatment in the world but if they can't kind of face the music in the morning and get up on time and make their bed or clean up after their dishes or do any of those things, you get a very sophisticated kid who's treatment savvy that doesn't behave any differently, right, and how do you program that? How are you programming that in? How are you helping staff do the balance? Yeah well so I.

Speaker 2:

He said so there's so much meat on the bone with what you just said there and it triggered a thought and it's something I heard a long time ago, and it's this idea that sometimes our, sometimes our criticism is worse than the conduct we're trying to correct. Right, and that was the problem with that was a problem of behaviorism is the reaction from the staff was actually worse than the behavior they were trying to correct and it creates secondary trauma. I mean, you'll never get away from secondary trauma in residential programs. So there's two issues that a student I was always trying to manage. Number one is primary issues the reason why you came here in the first place, that those are the primary issues and a good clinician and a good treatment team, including resident staff, direct care staff, will keep the student focused on the primary big ticket issues.

Speaker 2:

But Anytime you move to a new environment, that environment is going to generate secondary issues. That environment is going to generate secondary issues, right. So when, when I moved to america from the uk, I had to adapt to a new culture, I had to adapt to new mores and values and man, the first thing I stood out was bloody. I've never seen it. Americans are so patriotic. This is 25 years ago. Things have actually quite changed since then, but, but. But I remember the patriotism was like I'd never seen anything like it and and it brought some stuff out in me actually became prideful of my own country and sort of rebelled against the american values a little bit, because it wasn't who I was. My point is I had to adapt.

Speaker 2:

Any time a a student comes to a program, that program will generate secondary issues. He's now dealing with a new authority figure in his life. He's now dealing with a new school environment and the biggest hurdle will be his peers who come with their own baggage and I'm not talking about their luggage their own emotional and behavioral baggage. So you've got all these personality conflicts and a program. One of the biggest mistakes a program can make is to get focused on the secondary issues. For a treatment team to talk about the personality clash that billy's having with his roommate no that that may be a part of his treatment equation, but there's a likelihood that it's not. So a sophisticated team can go. You know what there are, these secondary issues that being in a program in and of itself are going to generate. But we're not going to focus on that. We're going to focus on the reason why he's here in the first place. So if we see impulsive behavior at home, we should expect to see impulsive behavior here and we can address it in real time. When we see oppositional behavior at home, we should see it here. We can address it in real time. If we see poor academic performance at home, we should see it here. We can address it in real time. If we see poor academic performance how, we should see it here and we'll address it in real time. All of those things qualify to be spoken of in within the treatment team because they're primary issues but programs often get derailed by the secondary issue.

Speaker 2:

Now another thing that happens in residential treatment. So the first iteration of residential treatment was behaviorism and then it moved to this new buzzword. It was relational change, right, relational influence. That was the second iteration of residential treatment and it has its problems and one of the major problems is it's kind of gooey and it's kind of it's kind of abstract.

Speaker 2:

We're going to try and influence change, not by punishing bad behavior and wanting good behavior. We're going to do it through mentorship, through. At TOS we call it inspiring to personal relationships. So when I first heard about this relational model, there was no real framework to it and staff all they knew was relationships means trying to change and influence. Trying to influence change to relationships means we don't do the behavioral thing Okay.

Speaker 2:

So then what do you do? Well, we're going to leverage our relationship, my relationship with them, okay, well, how do you do? Well, we're going to leverage our relationship, my relationship with him, okay, well, how do you do that? And the way that landed was everyone had a different idea of what it meant to influence and inspire through change, through relationships, and a lot of people got it wrong. All of a sudden, blue, blurry boundaries that went to the equation and we had staff over-disclosing, we had staff getting enmeshed and we saw more safety complex enter the field. But the savvy programmers realized oh, you still need a framework. There needs to be, and it doesn't. What I've learned is it doesn't matter what framework you use. What matters is that you have one.

Speaker 1:

Yeah, and that everybody's on the same page. Yes yes, yes.

Speaker 2:

Everyone's got the same playbook is inspiring interpersonal relationships, which is embedded into our mission statement, which basically means we're going to try and influence change through relational power needs a toolkit still, and you need to be able to show staff. You can boil it down to brass tacks. This is what we don't do in the relational model and here is what we do, and I've also learned over the years that if you want to make it real effective, less is more. Don't give your team too many tools, because then the batman belt isn't around the waist, it's around the ankles you. You've over prescribed.

Speaker 1:

I'm gonna steal that from you. That's great. The Batman belt is not around your waist, it's around your ankle.

Speaker 2:

You've over-prescribed the toolkit, so less is more when I work and what I found to be the most effective is the Arbinger model, and Arbinger is actually a consultant firm. They go into businesses and they help businesses run efficiently and effectively. Then they branched out and started doing family work. The same principles applied from business to family.

Speaker 2:

Family systems. We went all in on that. It proved to be a very effective model, but to your point. It was effective because we were all now on the same page. So you do need a rigorous training program and it's never-ending. So the way I like to see training programs run is you are indoctrinated. In the first three days of T-Bose You're going to be attending a three-day seminar and then every week you will learn something again from the three-day seminar. Everything is repetitious. We call it slow drip training. We think is repetitious. We call it slow drip training. In order, in order for it to infiltrate the mind and the heart, drip systems constantly are drip, drip, drip, drip. Once a week you're going to hear again in a very formal structure transition, something you heard from the first three days and we don't budge from that training. It. It's repetitious training and it's proven to be very effective.

Speaker 2:

I remember being in a leadership meeting five years ago it was actually 10 years ago, ten years ago and one of the mistakes we were making in our leadership meeting. Our leadership meeting comprised of we would. Our leadership meeting comprised of collaboration and then training, and in the training section of our leadership meeting, someone would always bring in a shiny new toy. Oh, I just read this book, crucial Conversations. So now I'm going to teach you leadership principles from Crucial Conversations, and then the next week, oh, I've just learned this book.

Speaker 2:

It was confusing, and I got to a point where I said guys, let's pick what our canon of scripture is, our leadership scripture is, and let's just train repetitiously on the same canon, and no one's allowed to bring anything new in unless we all agree on it. And eventually we all started speaking the same leadership language. We all had the same culture, we all had the same mindset when it came to leadership, because we all got on the same page. Again, it didn't matter what, what canon we used. What mattered is that we picked one and we stuck to it.

Speaker 1:

Right so I think it's the same for residential trip, residential programming.

Speaker 2:

If you want an effective residential program, pick your philosophy, make it pragmatic, actualize it, keep it simple and train on it doggedly, week after week after week. My goal was always I want people to sit in one of our training sessions weekly training sessions and say, oh, bloody hell, we're learning about the consultant.

Speaker 1:

We've heard this so many times to me, that's a victory so many times that you could give it yourself yeah and you know what I know about managing that level of staff is that if you're the person who's sitting there I've heard this so many times and I know that you know it person who's sitting there, it's like I, you know, I've heard this so many times and I know that you know well enough that you can. You can teach it and the chances are good. That is what you're doing. You're out there with people who are coming in, who are new. It's like, well, let me just tell you about this, because this is the model and, like you know, it's like an echo. It's like an echo that goes through your organization is it's? It's inescapable. Your clients, you, you know, your residents hear it, your staff hear it, new and old and everything else.

Speaker 1:

It's not, you know, and I think that I think people get worried about, you know, losing the creative spirit of a, of a process. It's like, well, you couldn't possibly lose that. Like you've got. You've got different people who are going to take this methodology and they're going to make it their own and it's it's going to have a character that is unique to them. So it's still going to live inside the structure, which is where we needed to live. It's when you start, it's when you go outside of that fence and start making stuff up that we start getting into trouble. One of one is that whatever you're doing is probably not verified. Second, whatever you're doing, nobody else knows, so you probably haven't communicated it to everybody else. And three, if you get into trouble, we don't even know how to come get you because you've gone outside the fence. Yeah, yeah. So I mean it's One of the greatest challenges a treatment program mean.

Speaker 2:

It's one of the one of the great. One of the greatest challenges the treatment program is going to have is getting all of the care providers on the same page working with teenagers who are actually really talented at manipulating we're talking about kids who can split their two parents very easily to split a village. Is it's it, it is it. It happens frequently and and students they pride themselves on doing it. So to have a common language and a common practice that everyone is behind and understands is a game changer and a structure.

Speaker 1:

I mean, you know, I think about you know, all kids try to split their parents, right?

Speaker 1:

I mean, that's just how it is yeah, um, yeah, and I I think about my kids like so, dad, you know, can I, can I get this? And everything else is like, did you already ask your mother? Hey, mom, what did you say? It's like, well, I told him he had to wash the dishes before he did that. It's like, oh, did you wash the dishes? And he's like, well, I mean not. Yet I'm like sounds like you probably need to do the dishes before I say yes to this, because your mom has already set down the limit.

Speaker 1:

And if the structure is, is that we always check with one another. You know, we always agree on whatever it is that needs to be done, like there's the structure right and the kid's gonna try. He, he's going to throw, he's going to throw spaghetti against the wall, see if it'll stick. He's going to see if he can get away with it. I I don't blame him for trying, but when he, when, when that student learns that this structure exists it is all through the system and it cannot be knocked down, the quicker they can get on with the thing they need to do. That is not manipulating the system, but investing themselves in the changes and the program and things that they're there to learn and grow from.

Speaker 1:

So, like I, you know I I love that answer and but it also sounds like part you've done this layering right. Part of it is behavioral. In general, it's like, yeah, we're going to set limits and you're going to get up in the morning and you're going to clean up after yourself and you're going to make your bed and there are things that you can do. And if you don't, if you choose not to do those things, I can't force you to do them. It's going to. It's going to have an impact not only on you and your progress, but also in your community and your privileges and your everything else. It's like and if you can show that you can do those things, well, then you get the privileges and you get the next leg up and you need whatever it is and it is so important to highlight, though, but that's not why you're here.

Speaker 2:

That's not why you're here. Right, you know all that. All that does is create order so you can focus on why you're here and the more time you spend fighting the system and the structure. I mean. I can't tell you how many times I've had a conversation with students as the executive director saying look, you're making a mistake. Executive director saying look, you're making a mistake. You've declared war on TLOs and its infrastructure as though it is the problem, as though that is your work. Your work isn't to come here and change TLOs. That's mission impossible. Tlos is what it is. Your work is to align with me in declaring war on the real problem, the things that got you here in the first place I'm not talking about your parents.

Speaker 1:

I'm talking about your destructive decisions.

Speaker 2:

Let's get focused on that so you can keep trying to change the system and manipulate the system, and some days you will manipulate this system. Well done. One point to you, but don't move the needle and get you closer to where you need to try and get to. So that's the big. That's the big uh struggle for a lot of the students is that once they've accepted they're here, there's still that manipulative. I'm going to change the system and declare we're on the system. So that is the work. No, no, the system is what it is and it's designed to create order. So you can remember why you are here and you know. If you want, if you want a day to feel like a year in residential treatment by the system, if you want a day to feel like a day, do the do the work that you were, that you're assigned to do?

Speaker 1:

I've got a parallel that I'm curious to, because I I know that telos is also very experiential in nature, which is a you know is a big part of my background as well using using experiential activities.

Speaker 1:

You, you know, trust, exercise. Maybe it's an icebreaker, maybe it's stepping stones, or maybe it's a wild woozy, or maybe it's any of these others. Like you know, in the theory that guides us to use those activities effectively, the activity is a microcosm. Yes, the activity itself is actually not that important, not that I didn't put some thought into what activity is going to fit this group for whatever they're struggling with. Sure, that's there, but the activity is not why we're here. Right, the activity is designed to bring out stuff that's going to be, that's going to have, you know, whatever these issues that are brought up by this group are going to be issues that each one of those members and the group as a whole probably experiences out in the real world, and they're going to recognize those things when they start to emerge. And that is why we're here to get to engage in a process that causes the real reason why you're here to emerge. So we can work on that.

Speaker 2:

Yes, yeah, well said, I mean that that is. That is the way I see the clinical world as well, and, if I may use an anecdote to please, to build upon what you just said, and one of the frameworks we use at tloss is exposure response, prevention therapy, which, for the layman, what that basically means is you're going to be exposed to the things you typically avoid and you're going to do it in a gradual way and eventually you're going to learn resilience and learn to adapt to that which distresses you.

Speaker 2:

So one morning a student of mine wakes up and he's shocked to see me sat at the end of his bed with an envelope in my hand. He said what are you doing here? I said, oh well, therapist, that's early this morning, I've got something for you. And I gave him this envelope and he opened it up and he says it reads I invite you to become an 80% free throw shooter with a basketball and he said what does that?

Speaker 2:

mean? I said it means what it means. I'm inviting you to become an 80% free throw shooter. He said I don't get it. What's that got to do with my therapy? I said well, if you think it's about basketball, you've missed the mark. Basketball is just a means to an end.

Speaker 2:

He said I don't understand what you're saying. I said look, you're here because you don't do hard. You haven't learned that yet. You haven't learned how to tolerate distress yet. You haven't learned how to ask for help yet. And when you are faced with something that's uncomfortable, you avoid and just look for dopamine hit after dopamine hit. So my job is to train you, um and use mental and emotional skill set. He said but what with a basketball? I said yeah, because to become an 80 free throw shooter, you're going to have to ask for help. You're going to deal with setback after setback, failure experience after failure experience, and this is going to be incredibly distressing and frustrating for you. He said I'm not doing it. I said I can't make you do it. I'm inviting you to do it, but you don't get to pass, go and progress the natural, natural consequences. You won't progress in your treatment until you do it. So the first three days was. He's a dick I hate him.

Speaker 2:

He's a mother effer. That was the first three days. We get to day five and he starts negotiating, trying to change, change the uh, the resiliency challenge. Yeah, and I said nope, nope, sometimes in life you dealt a hand that you don't get to choose. You just have to adapt, and that's what I'm asking you to do. You're so good at trying to negotiate the system and change the system to suit you. It would be a disservice if I changed this for you. I'm not going to do that.

Speaker 2:

Day seven comes and he decides oh, he means it. The only thing that can happen here is me accepting. So he goes out to the basketball. Now his baseline of shooting a free throw. Of every 10 free throws he he took, his baseline was maybe one or two out of 10, so clearly he wasn't going to figure this out by himself, out by figure this out by himself. He's going to need coaching. So he spends the next two weeks launching basketballs at the rim and he probably goes from a 10 free throw shooter to a 20, maybe 30 free throw shoot and he gets frustrated and quits, which was predictable. I gotta do this stupid tries to renegotiate with me. No, no, I'll budge it. I've told you what I expect from you, and remember, this isn't about the basketball, this isn't about the free throws. This is about everything you're going to have to deploy to become an 80% free throw shooter Eventually.

Speaker 2:

He allows me to give him some advice and I say if I were you, I would find the best free throw shooter on staff and ask them to coach you, which means you're going to have to ask for help. I don't know how you feel about that, so good luck with that. But that would be the next step I would take if I were you. And eventually he did. And he asked one of our staff, devin, who was actually close to a 90% free throw shooter, to coach him. So Devin paid a price and Devin spent a couple of sessions with him. So now he goes from being a 10% free throw shooter at the beginning, gets a week, two or three, he's probably 20%, 30%. With Devin's help help he gets to like 50. So we're moving the needle. And now it's about persistence and it's about stick-to-it-ness and dealing with frustration and planning time every day to go out to basketball. And I cleared his schedule. I sent a memo out to the school saying hey, instead of this student going to um homework period, if he's done his homework, please release him so he can practice on the bicycle cart. So we afforded him the opportunity to practice as much as he could and um, eight weeks down the road, that week eight is the day of reckoning now to be an 80 free throw shooter.

Speaker 2:

I remember he, he excitedly ran up to me about week number 14. Hey, barry, come here, come here, I want to show you something. And he said I think I can do it. And I said, oh, okay, and he puts 10 free throws up and he hits seven out of 10. And he said I'm a 70% free throw shooter. I said no, to be a 70% free throw shooter I'd need you shooting 100 and hitting 70 out of 10. Any dog on his day can hit 7 out of 10. I'm asking you to throw 100 up and get 80 out of 100. Oh, and he got so angry and frustrated.

Speaker 2:

But fast forward right week number eight. He's at the free throw line and this is the day of reckoning. He's putting 100 free throws up. He's got to hit 80. Don't do it. He hits 60 and he's so discouraged he cries. And I said what the tears about? I said today's worth celebrating. He said no, because I didn't hit 80 and I really wanted to hit 80, and now you're going to make me do it again. I said no, no, no. It was never about 80 free throws.

Speaker 2:

I kept telling you that all I wanted to see was the journey, the journey of setback and persistence and grit, the journey of the growth mindset, the journey of being exposed to that which you typically avoid and pushing forward in spite of setbacks and failures. That's what I wanted to see, and today you landed. It was never about the basketball and and it was a. It was a victory worth celebrating because of the journey.

Speaker 2:

The destination was far less important than the journey, and good clinicians and good treatment teams and programs understand that premise, that you know if, if we're doing a trust fall, it's not really about the fall, it's about what the fall represents. And we're going to tether this back to you pre-treatment and the traps you used to fall into and project what post-treatment can look like. If you learn this new way of being and to make that connection is so important and you think, well, well, duh, that's obvious, but there's so many clinicians, even so many clinicians, who fail to recognize. Sometimes the clinicians think it is about the chores, or it is about making the bed, or it is about not swearing. Well, it can be if that's why the kids here in the first place, like, if the kid's got poor executive functioning skills, then it is about making the bet, but if he doesn't, don't die on that hill.

Speaker 2:

Get focused and target what matters most. There are big tickets. I I never, I never call you look at kids treatment. I never call the issues clinical issues. I call them big tickets and small tickets because big tickets are what we should focus on and small tickets is where you get lost in the weeds. You can meet with 10 therapists in a program and three of the therapists throw the dart. If the dart board represents the big tickets, three therapists could throw darts at the dart board and miss the dart board. Four could throw darts at the dart board and at least hit the board, but the best hit the bullseye. They can see the chaff and they can see what matters most and they stay ultra focused on what matters most. And there are lots of clinicians who have that talent. We've got that skill and it is a game changing skill. But again to your excellent point, tug, that you know treatment is about making these powerful connections and and making sure that you you are connecting what's happening right now to the past and the present, the projected future.

Speaker 1:

Yeah, you're giving it the reflective. Do so that it can mean something the next time you run into it. Yeah, I tell you, it would be a lot of fun to kind of get out and do some training together. It'd be fun to go do some experiential activities with a group of people, you and me. I think we'd have a blast.

Speaker 1:

I think we'd have a complete blast and I really appreciate just the time that you're taking to to give people what they need to work with the kids and and I, you know, part of why I do this show and part of why I want to have this conversation is because you know there's so much news out there and everything else People really don't understand what treatment is and you know I can imagine a parent listening to this conversation and just being like, wow, you know I I can approach this in a whole different way than you know, dying on the hills I've been dying on or or being unable to do these things and probably also recognizing a time when they run against their limits and might need help. You know parents need the same thing right.

Speaker 2:

Yeah.

Speaker 1:

I think we're definitely going to have to pick this conversation up another time, because I've got so much more. I just want to pick at your brain, barry. Thank you so much.

Speaker 2:

Thank you.

Speaker 1:

Absolutely. This has been WPBM 1037, the voice of Asheville Mental Health Matters. I'm Todd Weatherly, your host. We'll see you all next time. I'm your super little rock. I found the elite out there. I'm used to the legal arts in here. I found the elite out there. I'm used to the legal arts in here. I found the elite out there. I'm used to the legal arts in here.

Speaker 2:

I found the elite out there. I'm used to the legal arts in here, thank you. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. Bye.