Transitioning to Life Beyond Gateway

Discharge and Transition

A teen's journey through treatment is all their own.  Similarly, the final treatment phase in a youth's journey at Gateway is likewise uniquely their own.  Whether they are bound for home, college, or a boarding school, we are focused on creating skills and structure that our youth and their families can take with them following discharge. With that in mind, research points to two factors that successful discharge and transition outcomes have in common:  1) active family participation, and 2) opportunities for practicing and solidifying new skills in the community and at home.  

Gateway youth may discharge and transition from Gateway's main campus location, or from the Gateway House.  In either event, Gateway plans for a youth's successful discharge both at the beginning of their stay, and continually throughout their treatment.  All discharge and transition planning includes the entire Gateway team in coordination with the youth and their parents.  

Making a Successful Shift

Careful discharge and transition planning is key to a youth's ability to sustain gains following treatment. Thus, months before a youth's discharge and transition, each youth's therapist work closely with the youth, their parents, and our experienced transition therapist to design a transition "sustainability" plan.  The transition sustainability plan will include targeted opportunities for the youth to practice the therapeutic skills and gains they have learned in treatment, including forays into the community, structured interventions, time with family, and a myriad of independent experiences.   

The youth's final discharge plan will be formulated by their therapist.  The discharge summary will be an overview of the youth's treatment history, including progress they have made toward their treatment goals, while providing recommendations for future treatment needs.  The level of structure and support each youth will need post-Gateway, as determined by the family, the youth, and the treatment team, is the vision that sets the roadmap for their successful transition.

Gateway Solutions For Sustainability

Research shows that youth and their families may experience increased stress preparing for transition and following discharge. While it is an exciting time, it is also a time where additional support is needed. For this reason, Gateway developed the Gateway-Solutions Transition Program, a partnership between Gateway and Solutions Parenting Support. This program is designed to help parents create a home environment to sustain the therapeutic gains youth make at Gateway. Once a youth earns their first home visit, parents are given access to online material to help create a sustainability plan, prepare for each subsequent home visit, as well as support the path for final transition.  For some youth, parents may choose to continue working with Solutions Parenting Support following discharge to support a youth's transition.

The Gateway House

The Gateway House is located around the corner from Gateway’s main campus. The Gateway House provides a step down in clinical services and support compared to Gateway's main campus. With clinical recommendation, youth may transition from the main campus to services at the Gateway House.  

Youth at the Gateway House have unsupervised, unstructured hours each day to function more independently and to challenge themselves with exposure to many of the circumstances or stressors in the outside community that may have contributed to their need for treatment.  Youth have the chance to try out fledgling skills in an atmosphere of greater flexibility and freedom. It’s a period of applying the treatment gains they’ve made to new contexts—with the full safety net and support of Gateway behind them.

At the Gateway House, the emphasis shifts from clinical intensity to community-based in vivo (“real life”) interventions and increased independent choices. Will they choose to study at 5:00 p.m. or 8:00 p.m.? Apply for a part-time internship that interests them, or volunteer at one of the many businesses with which we have connections in the local community? They may opt to sign up for a community sports league at this time or join a local yoga studio or climbing gym. From getting themselves up, fed, and ready for school in the morning, to deciding how to balance free time, study and fitness, each youth—within their own individual abilities—is given the chance to test and refine new skills little by little.

Youth will engage in individual therapy, family therapy, and group therapy as well, where the topics will focus on transition planning and the future. A carefully designed curriculum, considering the possibility of regression during this period, is followed week by week, allowing the family and youth to monitor progress at every step.

The Gateway House is also a time for exposure to aspects that are inevitably part of life. Electronic privileges are gradually introduced and learning how to balance time on the Xbox or an iPad with studies, fitness, and community involvement is critical to a teen's success. Youth are asked to set a weekly schedule and share it electronically with the group, outlining their plans for studies, fitness, volunteering, or recreational outings.

For those who struggle with anxiety, trust, and social issues, we are watching as they try out budding relational skills in the community. It’s an exhilarating emotional period, one of success and setback, triumph and trial, all intentionally guided week by week until each young person is confident and prepared for their next step.

Mirroring Life at Home or Their Next Step

During their time at the Gateway House, we begin to focus on mirroring what life will look like beyond our walls. For youth that are out of state, a plan is made for regular home visits at key milestones throughout this final phase. During this time, youth are assigned tasks such as interviewing aftercare therapists, visiting potential new school settings, interviewing for jobs, and locating recreational outlets in the home and community setting.

At the same time, youth are working on setting up connections and practicing healthy transitional behaviors, parents will work with our Transition Therapist to address the inevitable apprehension of a youth transitioning out of the Gateway House, as well as to put in place structures that will ensure their success and sustained well-being.

With each consecutive step, layers of responsibility and stressors are added, so eventually each youth's schedule and experience look just like it will when they leave Gateway. Both youth and their families can visualize what to expect; what’s more, they've had the chance to practice repeatedly the skills and self-advocacy they will rely on every day.