A Light in the Deep: Choosing Residential Care When Outpatient Isn't Enough
Licensed clinical social worker Tiffany Silva Herlin begins a miniseries with mother-daughter duo Jessica and Erika, who share their journey through eating disorders and depression. Their story highlights the emotional transition from outpatient care to residential treatment at Discovery Ranch South, offering guidance and hope to families facing similar mental health crises.
Real Stories, Real Healing
More Than a Patient: A Daughter’s Journey to Reclaiming Her Joy
Life Worth Living: Building Resilience and Connection After Treatment
If your family is navigating a similar journey and you’re ready to explore a path toward healing, please call us today at 855-667-9388 to speak with a professional who can help you understand the options available for your child’s care.
Introduction, Family Background, and Motivation
Tiffany: Welcome to Beyond Outpatient: Real Stories of Residential Healing. I'm Tiffany Silva Herlin, a licensed clinical social worker, and I'm so glad you're here. This three-part miniseries is for parents who are asking some really hard questions: Is what we're doing enough for our teen? What happens if it is not, and how do we know when it's time to consider something more?
Through the real-life experience of Jessica and her daughter Erika, we're going to walk through what it actually looks like to make the decision for residential treatment, what happens during the process, and what life looks like after. This isn't just a story about treatment; it's a story about family, fear, growth, and healing.
And most importantly, it's a reminder that you are not alone in the process. Please remember that this podcast is not a substitute for therapy. Always consult a licensed mental health professional regarding your family's specific needs.
You guys, thank you so much for taking the time to come and tell your story here today.
Jessica: We appreciate the opportunity. Thank you.
Erika: Thank you.
Tiffany: Yeah. I am so excited for our viewers to be able to hear your story so far. Talking to you guys prior to filming, you guys have an awesome energy. You're adorable. I'm so excited to hear your side of things. And Mom, you come with just this passion I can feel, and love for your daughter, and coming to where you got here today. I'm excited. Our viewers should be excited to hear your story, so let's dive in, shall we?
Jessica: Let's!
Tiffany: Okay. My first question that I always start with is: tell us a little bit about your family, and why did you want to share your story here today?
Erika: I'm very passionate about the ocean. I love my family. I love my friends. I have a lot of passion for life, and I love the outdoors. It brings me so much joy. And I also love my dog, Tucker.
Tiffany: And why did you want to share your story here today?
Erika: I think it's important for parents to get the perspective of a parent who has had a kid in treatment and a kid who was in treatment for a while, and getting to know the insight of what it's like for the family and for the kid.
Tiffany: I agree. I love that you're willing to come on here. It's super brave, and it takes a lot of courage to be this vulnerable and share your story to whatever degree you're willing - which is amazing, honestly. And parents do - they need to hear your side just as much as they need to hear your mom's side. Your side is just as important. So thank you. How about you, Mom?
Jessica: I'm so appreciative of Erika and her bravery to share her story. Because it's so intensely personal, and not just to her, but to our family. Erika has a mom and dad and one brother and three sisters, and she's the youngest of four. And the funniest of all of us.
Tiffany: I can see that.
Jessica: A lot, a lot of great energy and just a joy to be with and around, and her passion. And I would say like returned passion -
Tiffany: Yeah.
Jessica: - for life, and to do things you can only do when you're living. And it brings me so much happiness to hear her talk about future things and what she wants to do.
Tiffany: Yeah, because we're going to dive into where your journey started. Oftentimes, with families that we talk to, the future's not really on the table. In fact, there's a lot of question marks about the future, and discouragement, and loss of hope.
Jessica: Absolutely understand that.
Tiffany: Yeah.
Jessica: Have been there. What, in the depths of despair and not knowing if there was hope, what I could hope for. I... and so lost. It is really something to share and say that we are on the other side of that.
Tiffany: Yeah.
Jessica: And you can get through, because in the other - the first side of it - before going through a journey, just don't know what it's going to look like.
Tiffany: Oh yeah.
Jessica: And it's very scary, and unnerving, and each day you might have a different idea of what it's going to look like. So I'd love to break that down and help people to understand that. And I know Erika has a passion for people to understand that as well.
Tiffany: Which is why I'm excited to talk with you guys about this. For viewers that aren't watching and maybe just listening - like you guys, and I genuinely mean this, really bring a light, and a passion, and a love. I can see it in your eyes. You guys really do emulate it. And thank you again.
The Decision to Seek Treatment
Tiffany: Let's start with what brought you guys to this point of needing to seek out treatment. That is a journey in itself.
Jessica: Yeah, and not a short journey either. What I learned is that everybody's journey is different.
Tiffany: Yes.
Jessica: Some have a shorter path to getting to a place where they need residential care. Some have longer journeys to reach that point. Ours, I felt, was a little bit long. Our decision to go to Discovery Ranch was the last choice. It was the ultimate; if all the other things didn't work, this was going to be the last thing that could work.
Tiffany: The last resort. That's pretty common, I think, for a lot of families.
Jessica: And saying "last resort" was really difficult at times, because how could I articulate that to my child in a way that didn't come across as, "This is your last chance"? Because it wasn't a last chance. It was the best final resort to help her. I felt terrible having her feel or think, "Oh, I'm just being sent away because I'm not a good person."
Tiffany: Yeah. Or because, "My parents don't want me," or "I'm being punished."
Jessica: You're right.
Erika: Yeah.
Tiffany: Yeah.
Erika: It was definitely a long journey before I went to Discovery Ranch - in and out of other facilities, different schools, and trying different things at home to try and help. But ultimately, we had to go to a bigger residential facility like Discovery Ranch.
Jessica: Yeah. I'd like to share a little bit more detail of that journey.
Tiffany: Yeah.
Jessica: I feel that it might help others understand where we had been. In my experience talking to parents, they often don't know how to get the help they need or where to start.
Tiffany: Erika, how did you recognize that you were struggling at the time, or did you recognize it?
Erika: I knew I was struggling right up to the point where I went to a facility before the ranch. I knew I was struggling, but I didn't think I was struggling enough, or that it was that bad. I thought it was something I had under control, which was definitely not true. I really didn't have it under control. I struggled with an eating disorder on and off for many years, along with depression, anxiety, and suicidal thoughts, ideation, and attempts. It would ebb and flow. It was very up and down, but it never got better. After each facility I'd been to, it just always went back and got worse.
Jessica: I appreciate how she explained that. I think at first, when signs start to happen, there are easy ways to reason things away with young teens. They are changing and growing every single day. There is so much happening with maturing, especially when you think of a child between 15 and 18 years old. I felt grateful as a parent that I'd had older children...
Tiffany: I was going to say-
Jessica: ...to understand.
Tiffany: -yeah, that's super helpful.
Jessica: I can imagine that for families with only one child, or a first child going through a struggle, it is hard not to have the experience of what a "normal" teenager is like. As I tell people, you can't inoculate against "teenager-ism"; it just is there. So, what's "normal"? What's "not normal?"
Tiffany: It's hard as a parent. Having teens myself and being a therapist, I often have to ask, "Okay, we're crying and struggling today... is it a big deal or just a little deal?" Oftentimes they don't want to tell you, right? They don't want to talk about it. As a parent, and of course as a therapist, I tell myself, "Don't jump to the worst conclusion." They're always like, "Mom, I'm just having a bad day," and I'm like, "Oh, okay. Good."
Jessica: Also, being the parent, I wanted my children to trust me and share things with me, but...
Tiffany: A hundred percent.
Jessica: ...I'm the parent.
Tiffany: Yeah.
Jessica: Naturally, they're going to hold things back because of fear. They don't want to face judgment or be thought of negatively by a parent.
Tiffany: Or they are worried about the reaction, or they just want independence.
Jessica: Absolutely.
Tiffany: From us hovering. Which we don't "hover"... but sometimes we do.
Jessica: Yeah.
Tiffany: Yeah.
Recognizing Signs of Distress
Jessica: In all of that, there are times when I thought I could have done more or done better. I could have, would have, should have. It is hard not to beat myself up for not recognizing some of those signs really early on.
Tiffany: Yeah.
Jessica: So, I've had to focus on recognizing patterns, knowing my child, and really holding to the core of myself - knowing that I knew my child and I knew what was happening was not her. Something didn't feel right or go right. Then, learning through treatment... we started with some counseling, then-
Tiffany: So, outpatient?
Jessica: -so, just a therapist and talking. But deciding when to medicate and how to medicate was also something that was foreign to me.
Tiffany: Yeah.
Jessica: It was not an experience I'd had. I am big on addressing the issue and seeing what it is, but I am not opposed to medication if it's needed. There were also extenuating circumstances globally at the time she was struggling. We didn't have access to friends as quickly; a normal school situation just wasn't happening. Being able to access and find the right kind of care was a struggle.
Tiffany: Are you referring to the pandemic?
Jessica: Yes.
Erika: It was coming out of COVID.
Tiffany: Yeah.
Erika: When I was a freshman, that's when the quarantine ended.
Tiffany: Yeah.
Erika: Things started to get back to normal, but there was still the mask mandate.
Tiffany: Yep.
Erika: School was a little off.
Tiffany: Honestly, as a therapist, I've always wondered how that affected teens who were really struggling with their mental health at the time. I could only imagine.
Erika: I think it made it worse. Yeah.
Jessica: It was pivotal. She was between the middle of eighth grade and the middle of freshman year.
Tiffany: Oh my goodness.
Jessica: And-
Tiffany: It's such a crucial time.
Jessica: Absolutely.
Erika: It started when I was in seventh grade. That's when everything shut down, and we were full-blown at home. We could not leave. I couldn't see my friends, and I just know that changed my brain. It changed the way I think. I was growing up a little bit away from society during a really rough-
Tiffany: Isolated.
Erika: -time. I was, yeah, I was isolated. All I had was my family and my moody sister.
Tiffany: Sisters aren't moody. What are you talking about?
Erika: Well, this one is.
Tiffany: Totally joking.
Jessica: Erika and her older sister are the closest in age in our family. They are two years apart, so they did a lot of things together as younger children. But then one is two years ahead, changing exponentially in those teenage years, while the other is still young.
Tiffany: Yeah.
Jessica: So, there was the exposure to things. Also, when you have multiple children and one needs so much help with something, it can mask the needs of another.
Tiffany: Oh yeah.
Jessica: I felt that is what happened in Erika's situation. There were some acute needs that were masked because of things happening with her older sibling. When I finally realized Erika's needs, I felt like I was running into a brick wall. It hit hard.
Tiffany: Is that when you noticed she was struggling? What were some of those signs?
Jessica: I felt like there were some signs early on that you can reason away. Maybe it was just a bad day. Maybe there's just something she doesn't want to talk to me about. But the more you dig, the less you get. It became more of a struggle. With someone who used to be so close to me and shared so much, it became more divisive. The simple things didn't resonate as a "need" until a school counselor said that Erika needed specific help. She was sent to a place - we checked into a facility that would provide help - but how they do that is they admit them. They do the mental health assessment and pretty much keep them there for a week.
Tiffany: Okay.
Exploring Treatment Options
Jessica: Coming out of that, and then talking to other therapists, I learned that she needed help with depression. We tried a PHP program, and I felt that it was working. Then I found that she was making connections that weren't good. The risk is when you are with peers who are having struggles like yours, you are going to learn some things-
Tiffany: Yeah.
Jessica: -that aren't okay. That was worrisome to me. They were connecting outside of treatment or finding ways to still get into things that weren't good.
Tiffany: Yeah.
Jessica: When I learned that the foundation of the issue started with a struggle with eating and an eating disorder, that is when I felt it hit the hardest.
Tiffany: As a parent, that is where you feel like, "There is no manual for this. I'm not trained for this. This is bigger than me." There are often many mental health issues, whether it's an eating disorder, a suicide attempt, or a list of other things, where as a parent you think, "Whew, this is big. I no longer have what I need as a parent to support my child in this."
Jessica: True. And I thought, "What is wrong with me? I'm good at making sure there is nutrition and things in our family. What is this?" I learned better than that thought through her treatment. Actually, all the way through to Discovery Ranch, we learned things there that really helped us to connect well on the eating disorder part.
Tiffany: Interesting.
Jessica: It is interesting, because she had been in eating recovery twice. It was the second time she was there that it was very severe. It was after that that she went to the ranch.
Tiffany: Erika, what is it that you'd like us as moms or parents to know when you're going through something hard? As moms, we want to know. We want you to open up to us. We want you to be our little girls, to trust us, and to tell us what's going on. Help us understand from your perspective what is helpful and what is not, and why you might pull away and shut down during those tough times?
Erika: I think with the struggle of mental health, no matter how many people are around you or in your support circle, you still feel alone. You still feel like the entire world is against you. Sometimes, being approached felt like an interrogation, even though I know my mom was anxious and trying to figure out what was going on with me. I pushed back. I didn't know how to talk about it. I didn't know how to express what was going on, and I didn't even know what was going on myself. It was a very blurry time in my life. I would like parents to know that it comes with time; your child will come to you. Building trust means not bombarding me after school - giving me some time. My mom learned that pretty quickly: give me some time to rest after school, and I will come to you. After quite a bit of time, I started coming to my mom because I learned that I could trust her. Still, it's ingrained in my brain sometimes where I think, "I'm scared to get in trouble. I'm scared to talk to her about this." But then she reminds me, still to this very day, "You can talk to me about anything. You can come to me. You don't have to lie. You can tell me the truth." That helps because I realize, "Oh yeah, I can trust my mom. I can tell her things." I couldn't say that about all families, though. There are some parental struggles where the parents aren't very healthy for the kid. I learned that in treatment. I had friends there who were not close with their parents at all. They really struggled to even have a normal conversation. I tried to help as much as I could, but I think parents need to be patient - very patient with their kid - and wait for them to come to you.
Tiffany: I love that, and I love your perspective. Giving our kids space, time, and the ability to take a breather, right? What I'm hearing you say, maybe without meaning to directly, is that as parents, we have to do our own work. I am also a very anxious mom at times, and I often project that on my kids. If you have a parent who hasn't taken care of their own mental health stuff - whether it's big or small, a little bit of anxiety or something bigger - that is going to affect you guys. So, what I'm hearing you say is we have to do our own work, right?
Erika: Yes. In order to help your child, you need to work on yourself.
Tiffany: Yeah.
Erika: I know parents can have their own trauma and struggles, and that can be taken out on their kids or projected onto me. That's something you need to work on personally, and not bring it to me and add onto my plate.
Tiffany: I love it. I hope all our parents are listening. That is so important for us to hear as parents - and hard at the same time - but so important.
Erika: Yeah.
Prioritizing Eating Recovery
Tiffany: So pivoting back to Mom, it hit you really hard when she had gone through it and you guys had finally labeled it: this is an eating disorder, and that's contributing to a lot of other things. Then what was the next step?
Jessica: It was really important that Erika receive help with her eating recovery and stabilize with that before seeking anything additional.
Tiffany: Yeah.
Jessica: Because she had...
Tiffany: Why?
Jessica: She had to be healthy and at a level that could then be sustained. Otherwise, when a physical body cannot sustain the nutrients, she would have ended up in a medical situation. So, it wasn't the right thing to put her into any other place than an eating recovery center. Because we knew eating recovery already from a former experience and we knew the program, that helped. There was a therapist there that she worked with very well.
Erika: I love her.
Jessica: Yes. In fact, we will say that even for professional therapists, it's a really hard relationship to form at first, and when you find the right fit, it is magical. With that particular therapist, the first round of ERC was really hard for Erika to connect.
Erika: Because I went there twice.
Jessica: We wanted to make sure she had consistency in care, so when we returned, we had the same therapist.
Erika: And the same dietitian.
Jessica: And the same dietitian. We know them well, and we even have our own jokes about people who have been in our care program. It was a comfortable fit, unfortunately, but still, knowing the conversations we could have with the staff already helped. When she was ready to leave, it took a while. She was actually at ERC a little longer because we were getting things ready for her to go to DRS.
Tiffany: Okay.
Transitioning to Discovery Ranch
Jessica: We lined it up in such a way that she was home for one night, and then we took her to Discovery Ranch. We shared the news with her in a room with her therapist and the supporting staff there. I knew it would be a hard message and met with emotion by everybody. We went home, and she literally packed up her things in an almost willing way. She was not showing anger or dissension; she wasn't fighting back with us. But internally, she might have been.
Tiffany: She's giving you some looks. Do you want to speak up?
Jessica: Internally, she might have.
Erika: I remember saying a lot - I remember telling you and Dad, "I'll never forgive you for this."
Jessica: Correct. You did.
Erika: I was really mad, but I didn't resist because I knew I couldn't resist. If I resisted, then there would be external people coming in, and I didn't want that - that would just cause more trauma. I thought about it and just felt like I was being forced into this. I had to do it. So...
Tiffany: Did you want the help at that time, or were you still kind of thinking, "This is stupid"?
Erika: Nope.
Tiffany: Okay.
Erika: "This is stupid." When I got to the ranch, I was like, "Ooh, I was not ready to leave ERC." Before I learned I was going to the ranch, I had the full intention in the back of my mind of going home and relapsing. That was the intention in the back of my mind, but in the front, it was like, "Yeah, Mom and Dad, I'm going to be great. I'm going to be a good kid. I'm going to do so much better." That would not have happened if I didn't go somewhere else. While I was at ERC, I talked to staff and looked into residential eating disorder facilities myself. I thought, "Maybe I should talk to my parents about this. Maybe going to a place like this would be helpful." And then my parents came in and said, "There's this ranch in Utah, and we're going to send you there." I was like, "What? Why are you doing this to me? Why are you sending me away? Why do you want to get rid of me?" I thought, "This facility of all things? I have to raise a cow? What is this?"
Tiffany: Would it have helped - maybe it's hard to look back now, or easier to look back now - but would it have helped for your parents to try to get your buy-in and have you be part of the decision, or do you think you still would have said, "No way"?
Erika: Honestly, I wish I was part of the decision. If I was part of the decision, I would have chosen a different facility that had more experience with eating disorders.
Tiffany: Sure.
Erika: And had more...
Tiffany: Something specific toward that?
Erika: Specific toward eating disorders. The ranch isn't specific toward eating disorders; it's specific toward mental health and behavioral things.
Jessica: I would point to when she just said, "I had full intention to relapse."
Tiffany: Yeah.
Jessica: That tells you a lot. That is what I was facing with her as a repeat visitor to treatment centers. In fact, the very first place she went for mental health care - which the school counselor referred us to - she had been in that facility three times total.
Tiffany: And what was the length of stay there?
Jessica: The first two times were seven days.
Tiffany: Okay.
Jessica: The third time was shorter because we had a really great therapist inside who advocated for her mental health, saying it wasn't a good place for her to be. She was ill and could not be around anybody, so she was pretty much in a room.
Erika: I had the flu, and they wouldn't let me leave without getting tested for COVID.
Tiffany: Oh.
Jessica: She was really sick.
Tiffany: Okay.
Erika: I had a really bad flu. I was in a room by myself for days.
Tiffany: Yeah.
Erika: I learned how to do Sudoku.
Tiffany: That's good. That's good for your brain.
Jessica: Those experiences told me there had to be something longer and stronger.
Tiffany: I want to jump back and say I love that you guys talked about the need in any recovery - whether it's eating disorders, substance use, or any type of addiction - to take care of your physical body. You have to get to a place where you are sustainable. All those addictions can affect our physical well-being. As a therapist and a mom, when someone is emotionally off, the checklist is: "Have you eaten? Have you had a nap? Have you gotten enough sleep? Are you sick?" If those needs aren't met, it is going to be really hard to process how you're feeling.
Erika: Yeah, with my physical health, it was not good, and that affects your mental health. My mental capacity wasn't there.
Tiffany: Yeah.
Erika: Everything was a blur; everything was almost fuzzy. In order for me to work on my mental health, I had to work on my physical health first so I could actually focus and be fully there. I wasn't fully there because I wasn't nurturing my body. Food and nutrients are so vital to your mental health - extremely vital.
Jessica: See, this...
Erika: And I couldn't...
Jessica: This is...
Tiffany: Would she have said that before?
Jessica: No, absolutely not. I think she would have said the words because she knew they were what needed to be said, but she didn't really believe them herself. Because of her struggle with nutrients and feeding her body, she knew she wasn't doing the right thing, so she would turn to things that would satiate her in a different way, but still weren't good for her. That is what unraveled her into depression: "I'm not doing the things I know are good for me, and I'm a disappointment." It was just the shame and the poor self-talk.
The Cycle of Mental Health Struggles
Tiffany: Self-belief, yeah.
Jessica: I saw that cycle happen up and down, and a couple of other patterns emerged that I think are important to share. I identified these as signs that she wasn't well. She would return to school and do well for a short stint, and then eventually she couldn't stay. It would start slowly, where one day a week she wouldn't go to school, and then pretty soon it was zero days. Or she would step in the door, and then an hour later she was coming home; she just couldn't stay there. I realized that environment wasn't a positive experience for her, and she was struggling. She couldn't balance the feeling of "I need to be at school" with "I can't be at school because of what I'm faced with there."
Erika: I would call my mom maybe once a day asking her to come get me, and she - I stand by this - did the right thing. She came and got me. I needed that break. I couldn't handle being at school; it was so difficult in every single way.
Tiffany: Was that environment contributing to the cycle you were in?
Erika: Yes. It was contributing to my cycle of bad behaviors, like the eating disorder behaviors and things like that.
Tiffany: Did you present differently at home versus how you were at school or with friends?
Erika: Yes. At home, I was more shut down. I was more quiet and anxious. I was always in my room. I rarely came out, maybe only to go to dance when I was still doing that. When I stopped going to dance, I would come out to ask if I could go hang out with friends, go for a walk, hang out with my dog, or maybe make something to eat. So at home, I was just a lot more secluded. At school, it was the same thing. I wasn't a big talker, but with my friends, I was energetic. It really depended on the day, though.
Tiffany: Yeah.
Erika: I could either be super happy and energetic - just wild, regular Erika - or I could just be completely shut down, tired, and sad. I wouldn't really talk. I wasn't very big socially; I had a lot of anxiety with socializing. Especially with the school I went to and the kids there - it was not fun. I didn't like interacting with them.
Jessica: She is one to have few friends and remain really close to them. She did have a core set of friends that were like that for many years.
Erika: Yeah. I wanted to talk about what life felt like before treatment.
Tiffany: Please.
Erika: I was thinking about this the past couple of days when I read these questions. I read my journals from the ranch. I looked through old memories from that time before treatment, or the start of being in and out of treatment, before I went to ERC for the last time and before I went to the ranch. It is such a big blur, but I remember it was sometimes hard to even know what day of the week it was. All the days blurred together. I couldn't think clearly. I slept so much. If I had a couple of hours to myself - boom - I was asleep. If I had a job, I would get up and go to work, but then I'd go home and be asleep by seven.
Tiffany: Oh, wow.
Erika: I'd just sleep all day if I could. I wanted that time to pass. Also, I did not feel like myself. I was trying to fit in with other people and trying to please others. I was just trying to get through the day, and it was so exhausting. I was exhausted all the time and never had energy. I barely even had color in my skin. My hair was flat.
Tiffany: Yeah.
Erika: It's poofy and curly now.
Tiffany: You have beautiful hair.
Erika: Thank you.
Tiffany: For those who can't see it, it's gorgeous. I love it.
Erika: Thank you. It was just a huge difference. I was always sad; even if I presented myself as happy, I wasn't.
Tiffany: That's interesting. You talk about your physical attributes, because if you're not providing nutrients to your body, but also, I would argue your emotional state affects you physically as well. They all go hand in hand.
Jessica: Absolutely. And it's difficult because when a child is being medicated for depression, it's not just about upping the medication every time.
Tiffany: Yeah.
Jessica: That isn't always the solution. It might be part of it, but it's really about understanding and unraveling what's happening to get to the core of things. I knew after the first experience at ERC that it was such a core issue. She came out of treatment the first time and did so well, following along with everything. Then there was a short period of time where it was like stepping off a cliff. She completely nosedived, and that's what landed her back in ERC the second time in a more severe, acute way. The day they called me to say they wanted to give her a feeding tube, I rejected it. I told them no. I don't think you knew that.
Erika: I didn't.
Jessica: The feeding tube is given to help restore weight and nutrients, and to help the body function again to accept food. I asked the nutritionist to just give her some time - a couple of days. Let's see how she does; let's check in. There are check-ins they do with parents that the patients aren't aware of, and they shouldn't be. It's part of what is managed on the outside. Then there is what is done for the patient, which is just for them. Eventually, you bring that together through therapy, nutrition discussions, and learning. Nutrition is even kept very close, like a secret. It's held tightly because it is such a mental thing.
Tiffany: Yes. You don't want them finding those loopholes, or manipulating it, or getting around it. It's hard to say "we want you to be honest," but at the same time, we have to control this aspect.
Erika: I can tell you this: people with eating disorders, and mental health issues in general, are really good at lying.
Tiffany: Yes.
Erika: They are great at saying, "Yeah, I ate today." They are really good at hiding food. People did it even in treatment, and it was very strict so we couldn't do that.
Jessica: I learned from the nutritionist and the therapist the things that patients do to hold on to that control.
Tiffany: Yes.
Jessica: And then I also learned from Erika what she witnessed. But regarding the restorative part - finally, I said, "It's okay." I had to understand that for myself. It was what she needed. But taking her out in public with a feeding tube was interesting.
Tiffany: So she did eventually get one?
Jessica: She did.
Tiffany: Okay.
Jessica: We both reflect on it with some difficulty. There is some humor in it, but the public sees you as a sick person and-
Erika: I remember going out-
Tiffany: Which you are.
Jessica: They are, but not-
Tiffany: Not in the way people realize.
Jessica: They don't know.
Tiffany: Yeah.
Erika: I remember going out into public and people would stare. They would try to figure out what was wrong with me or why I had a feeding tube. It's so nosy.
Jessica: Maybe they just don't know what it is.
Erika: I remember this one time I went to Target with my mom and I saw kids my age. They wouldn't even make eye contact with me.
Tiffany: Yeah.
Erika: I felt so dehumanized. I didn't choose to have a feeding tube. I didn't want a feeding tube, but I had to have it, and I couldn't take it out. If I did, they would just put it back in.
Tiffany: That must have felt so isolating and lonely for you, especially amongst your peers.
Erika: Yeah.
Building Community in Treatment
Erika: But with my peers at ERC, it was the best community ever.
Tiffany: Yeah.
Erika: I still talk to them to this day. I talk to every single one of them.
Tiffany: That's so awesome.
Erika: Yeah, because they all went through the same thing. They were by my side at my worst. They saw me at my very worst, and I saw them at theirs. You keep those bonds forever.
Tiffany: Yeah.
Jessica: And also, from a parent's side, you want those bonds to be healthy. You don't want the bond to cause them to be in an unhealthy place again.
Tiffany: Yeah, I think you made a reference to that. I think it is a legitimate concern to feel like, "I don't want to allow my child to be exposed to new ideas that are going to make things worse," and yet the real goal is to get them to a place where they can find healthy relationships, right?
Jessica: Yes.
Tiffany: Because whether they're at home, at school, or in a program, if they're seeking out people to support whatever struggle they're having, the environment doesn't matter. The goal is to get you to a place where you're like, "No, these people are going to help me move forward on my journey, not hold me back."
Jessica: Yes, true. And one of the things I think helped Erika move forward in her journey was knowing I wasn't judging her for what she wants to believe and know for herself. She was finding herself at 16, 17 years old, and there's a lot of self-discovery in that time that launches a teen into young adulthood. I felt it was important that she received true help before becoming a young adult. Once you're an adult, my control over what she would receive goes away at 18.
Tiffany: Your support, your influence?
Jessica: My-
Tiffany: Your legal influence?
Jessica: Maybe more... right.
Tiffany: Yeah.
Jessica: My support and influence were stabilized in those years to help her now be a young adult.
Tiffany: Yeah. Was it hard to make the choice to send her out of state? Utah's not too far from where you guys were, but still, I think it's hard for a lot of parents to say, "We're going to send them out of state, far away."
The Fear of Sending a Child Away
Jessica: That's understandable. Anytime your child is out of reach, it can feel uncomfortable. I think for our family, because we had older children who had already lived away from home, it was different.
Tiffany: Okay.
Jessica: We had already established a way to travel and see family. We have always been a road trip family, which helped a lot. I put a lot of miles on my vehicle to visit; I was thinking about the time and how many visits we did. I think we'll get to this probably when we talk about DRS more.
Tiffany: Yeah.
Jessica: But sending her to Utah was not a difficult decision for us because of the proximity.
Tiffany: That's good to hear. For a lot of parents it can be difficult, especially if it's their only child or their first child.
Jessica: Across the country, we met many families that were not nearby.
Tiffany: Yeah.
Erika: People from places like Pennsylvania.
Tiffany: Oh yeah. New York - all over.
Erika: So far away. The Carolinas.
Tiffany: Yeah. So, I have two questions for both of you. Mom: how did you navigate the fear of sending her away? And Erika, for you: what were your fears about leaving home?
Erika: My fear with leaving home was missing my life - missing out on the rest of my teenage years. And those fears were correct. I did miss out on a lot. I've never been to prom. I didn't walk at graduation - that was a choice - but I didn't finish high school things. Sometimes, in the back of my mind, I still miss that and feel like I missed out. I was fearful that I would miss out on my friends' lives, and I did. I missed out on my sister moving in and moving out, starting a new job, and hanging out with her. That's what I was really scared of the most. I just... I did miss out on a lot.
Tiffany: Looking back, do you feel like your journey was worth it, even if it didn't necessarily "make up" for those things? Considering where you are today?
Erika: A hundred percent. I would rather lose about two years in total of my teenage years - before, during, and after treatment - so that I can live a full, healthy adulthood. So I can go travel the world. So I can go see a whale in person. So I can hike fourteeners and go on backpacking trips. It is a hundred percent worth it that I missed out on prom so that I can be a happy adult and find a passion for life, because that's what I did. I found a passion for life, and I wouldn't have if I didn't miss some high school or miss prom.
Tiffany: Those are pivotal things, and it's hard to hear as a teenager that you'll miss out on them.
Erika: Yeah.
Tiffany: One thing that I think is easier to look back on when you're older is that while high school scenes are hard to miss, there are so many better things ahead.
Erika: I can still dress-
Tiffany: Especially in college.
Erika: -up pretty on my own time.
Tiffany: You absolutely can. You could go dance in a beautiful gown any day you want, girl.
Erika: Yeah. And I can choose the venue.
Tiffany: Exactly. All the music you want. Yeah. How about for you, Mom? How did you navigate the fear of sending your daughter away?
Jessica: I didn't want her to miss out on teenage things because those do become core memories. For me, I knew there was a greater need for Erika and that we would be able to navigate the things she missed. It didn't make it easy that she missed things, and it certainly wasn't easy missing her. It's hard to talk about.
Tiffany: You were mentioning before we started the set that when she went away, it felt like a light dimmed in your life and your family.
Jessica: I missed her every single day.
Tiffany: Yeah.
Jessica: Every day. I missed a whole year of having her home, but fortunately, I saw her a lot in that year and saw so much change and growth. That is what solidified the very difficult decision to have her go to residential care. Navigating the decision to actually send her there... there were two sides to that. There was the side of: "This is the end of the rope. I can't do anything more for my child." I felt I was at an ebb. There had to be something bigger, or nothing was going to change and I was going to lose her. I could lose her permanently.
Tiffany: Which puts things in perspective. You both said something I've heard from many parents: yes, you're giving up this year, this birthday, or this Christmas holiday in order to gain back all the rest. It's just hard to see and feel that in the moment.
Jessica: It is absolutely hard to see.
The Trust in Treatment Decisions
Tiffany: Yeah.
Jessica: But you have to have the trust and faith that there is a light at the end of that tunnel.
Tiffany: Yeah.
Jessica: And there is light even in the deep...
Tiffany: Getting that hope back for your future.
Jessica: Yes.
Tiffany: How did you find Discovery Ranch South, and how did you know it was the right choice for your family?
Jessica: After my daughter had been in several places, I knew I didn't want the same thing because those weren't going to work. We would just end up going another round, and I could not do another round. I needed something bigger. I just did a Google search and started looking at long-term treatment; I didn't even know it was called "residential." I was really looking more for education because I didn't want her to miss out on school. I thought about what could offer education, like a boarding school, but she didn't need a traditional boarding school - she needed mental health support.
Tiffany: You were saying, too, that you had known about wilderness programs, but you knew that wasn't the right fit.
Jessica: Yeah, I knew about wilderness and knew it wouldn't be a good fit for her. I felt like wilderness was like going away to camp; you do a little stint for a while and then you still come home. I didn't really understand it, just like I didn't understand residential care.
Tiffany: Yeah.
Jessica: But I found Discovery Ranch and saw the information offered on their website. Then, I got in contact with an educational consultant who does reviews of residential places.
Tiffany: So, an educational consultant?
Jessica: Yes. When I gave that person the name of the place, they said it was rated well. These reviews happen frequently; the consultant visits locations often to reassess them because places go through changes. It was known to be a good place. I think one of the key things I liked about Discovery Ranch was that it was a ranch with animals. That was part of the therapy and the care. When a child has the opportunity to care for another living thing, it helps them know that they are cared for. I just really liked that platform and method.
Tiffany: Yeah, and I think your journey to finding a place isn't unusual for a lot of families. You go on Google, you try to ask around, and you make connections with other people. I think that's where a lot of parents start when they need residential treatment. Often, we don't even know exactly what we need; we just know we need something. I appreciate you explaining that perspective to other parents.
Jessica: I'd also like to say that there are ways to get care covered by medical insurance, though insurance covers some things and not others. I never looked through the lens of what was covered or not; I always looked through the lens of, "What does my daughter need?" I felt very strongly that this is what she needed, and the rest would just be managed and taken care of.
Tiffany: That takes a big leap of faith for a parent.
Jessica: It's difficult.
Tiffany: Yeah.
Jessica: Especially if finances are a stress - it's very difficult. That can be the deciding factor in not seeking care: the financial obligation.
Tiffany: Yeah. It's the choice between putting your kid's care first and just figuring it out. That's tough because you are already in crisis. You're going through trauma, and then you add that financial burden. All of it is just so incredibly difficult. Before we end this episode, for my last question: what message would you want parents and listeners to hear?
Erika: I have something. Your child is probably going to fight back a lot if they're not part of the decision-making process. They are probably going to say some things they'll later regret, but in the moment, they feel like, "This is what I think, and nothing is going to change that." I told my parents I hated them and that I'd never forgive them. Now, I thank them for caring so much and for helping me make the right choice - because that was definitely the correct choice. I don't know where I would be right now if it wasn't for my mom and my dad choosing this place for me to go. You just need a lot of trust. You have to put so much trust into the program and just try to trust the process.
Jessica: "Trust the process" is always a good quote because it's true. I think at the beginning, there's no trust on either side. A parent often knows better than a child who is young and doesn't have much life experience or an understanding of why they're making certain choices. I wasn't surprised when my daughter said, "I don't trust my parents; they're sending me away." I fully expected her to feel that way. I was grateful for the journey to start over with building trust. That occurred through the whole program, and that's where we are now.
Acknowledging the Challenges of Treatment
Tiffany: I love that you guys were able to come on here and share the hardest part of your journey - or at least part of the hardest part. Treatment also comes with its own challenges. Thank you for sharing what led up to the realization of, "Okay, we need treatment. We're in crisis. My daughter's not doing well." Erika, even if you didn't want to admit it then, you knew you weren't doing well; maybe we'll talk about when that perspective changed for you.
To our listeners, stay tuned. In our next episode, we're going to talk about what actually happens when you are in treatment, how families can survive the early days, and what you would like parents to know who are considering this. So, thank you guys again for your openness, your honesty, and for showing up today.
Jessica: You're welcome, and thank you.
Erika: Yeah, thank you.