When you meet Emily today, the first things you'll notice are her wonderful smile and contagious laugh. A very different young woman than the one who walked into Dakota Boys and Girls Ranch—who at that time didn't crack a smile, speak, or look up from the ground.
Emily was suffering from suffocating depression. She sometimes hurt herself on purpose and most days she refused to go to school. She had been in and out of hospitals and treatment facilities for almost five years without any relief. For Emily and her mom, Nora, Dakota Boys and Girls Ranch was the last resort.
"Emily was in a really bad place," Nora said. "My greatest fear was that I'd come home from work one day and she'd be dead. She'd have cut herself and the bleeding wouldn't stop, or she'd have taken her life while I was gone."
"I kept telling her, 'Just stay alive one more day'."
While dropping Emily off at the Ranch took some of the pressure off Nora to single-handedly keep her daughter alive, it was one of the hardest things she's ever done.
"Dropping her off at the Ranch was horrifying," she said. "It literally took me three hours to drive the 111 miles home that day. I kept having to stop because I couldn't stop crying."
It wasn't a great day for Emily either. She clearly remembers her first day at the Ranch.
"I was scared out of my mind," Emily said. "And, I was very upset. The whole cottage was going to the zoo that weekend and I couldn't go. I had to wait a week to do any off-campus activities."
The Honeymoon Period
Like most children when they first come to the Ranch, Emily didn't embrace treatment wholeheartedly. Katie Boucher, Case Manager at the Ranch, said, "Emily was smart about trying to find ways to not be part of therapy. The first month she was here, she was the perfect child. She had learned to hide her behaviors, emotions, and issues to prove to everyone she didn't need treatment, regardless of the history she brought with her."
For Nora, this careful honeymoon period was familiar. Her daughter had been in many treatment programs - all lasting about 30 days. Nora was terrified the Ranch would discharge her, like all the others, without ever seeing the behaviors that led Emily to the Ranch. "I knew she could pull it together for 30 days because she'd done it before. But, on day 32, the wheels would fall off and it'd start all over again," she said.
The treatment team at the Ranch listened to Nora and saw the fear behind Emily's perfection. It took 34 days to see the change in Emily that Nora knew was coming.
The Honeymoon is Over
"When Emily started to struggle she refused to go to school, refused to take her meds, slept all day, refused to talk to anyone, and had no ability to see alternatives to her choices," Boucher said.
About the same time, Emily started to hurt herself, this time with a simple school eraser. She rubbed her skin with it until she made a wound that bled. She hid what she had done from staff because she was scared. She was always scared. But, when staff saw the damaged skin, they gently cleaned, treated, and bandaged it for her, without rebuke or shame. Then, her therapist talked her through the incident with simple questions, like, "How did you feel when you did it?" and "When you have those feelings again, what could you do instead?"
It would be easy, from the outside, to think treatment isn't working when a child hurts themselves, like Emily, or flies into a rage or is aggressive. But at the Ranch, we know those are the windows into the child that give us a place to begin the healing. When kids end the "honeymoon" and start showing the behaviors they have struggled with at home, school, and the community, then we can teach them to recognize the emotions behind their actions. We can teach coping skills and show them they have options. If they never act out, they don't get to learn and practice those new skills.
The Importance of Family Support
In addition to Emily's individual and group treatment, Nora and Emily had family therapy sessions every two weeks--sometimes in person, sometimes via phone. Nora and her partner also did family therapy without Emily, and Nora saw a therapist in her hometown to work on her own issues.
Nora was very involved in Emily's treatment, and even though she often worried she was "that annoying mom," to Ranch staff she was a fully engaged, caring, loving parent.
"I talked to Nora sometimes several times a week when she needed to bounce ideas off me, or just hear that she made the right choice in placing Emily. She was such a blessing, and the kind of parent I wish all of our children had. Because she knows Emily so well, she was able to teach us what works for her and what doesn't," Boucher said.
"We encourage all of our families to remember they are the experts about their kids and that the feedback they give us is invaluable."
School was always a challenge for Emily.
Nora said, "Emily had such bad feelings about school. She avoided school a lot by making up sicknesses. She would even choose going to the hospital over going to school."
At the Ranch, it was different. "I liked school there a lot," Emily said. "It had fewer people and the people were nice and not mean."
Emily thrived in the small classrooms. She worked hard and gained the confidence she needed to ask for help until she understood. Nora said Emily had her best grades ever while at Dakota Memorial School, the Ranch's on-campus school.
Nora and Emily don't hesitate to tell people Emily was at the Ranch. They both want everyone to know spending time at the Ranch is nothing to be ashamed about.
"It works," Nora said. "I can't speak for everybody, but I think with the right family support and the support you get from the Ranch, it really does work. She learned a lot at school. Dr. Martinsen monitored her medications and made adjustments. Her mood picked up, and she learned new tools for coping. Ranch staff were phenomenal."
Emily has an inspiring story to share, and a promising future.
"She is funny, courageous, and was so kind to everyone she met here," Boucher said. "In completing treatment, Emily was finally able to put herself first. She chose to battle her demons so her depression didn't control her life anymore. We are so proud of her for working so hard!"
This article was originally published in Ranch Voice: Summer 2018.
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