Last week Pacific Quest staff members participated in a company-wide training focused on Horticultural Therapy and Rites of Passage. It was a great opportunity for the team to come together on our new farm property and have time to connect while learning new skills and strategies to work with our students.
The training began with an introduction to the Four Shields and the Neurosequential Model of Therapeutics that’s utilized at Pacific Quest and an integral part of our program. After the intro, the team divided up and spent the morning at various “stations” that focused on different learning objectives. Staff members had the option of picking which workshop they wanted to participate in. Some of the options included: Meditation & Mandala workshop, Cordage and Ti lei making, medicine walk and planting skills, soil & compost, and hard project skills & “imagineering”.
One of the main goals was to emphasize the importance of how to incorporate these various lessons and projects into the daily routine with students. PQ Field Therapist Sarah Blechman, who helped organize and facilitate the training comments, “The whole day was so engaging! It was abundantly clear the facilitators were authentically passionate about the rich union and incredible effects of the interplay between horticulture, rites of passage and how to facilitate the two using the neurosequential model. My favorite part was when our program guides, managers and therapists all worked together to create our first garden bed in our ethnobotanical garden. Working on such a large project together felt like the whole community was working on a gift for our new farm.”
Last week I was contacted by PQ to check in with my family; it has been about six months since my son finished the program. They asked if I had news or photos to share. I didn’t have any photos. I only saw him for a couple hours when I picked him up at the airport and drove him to the place where he would likely spend the next nine to twelve months of his life in a transition program. We had lunch and got him moved in to begin the next stage in his journey, and then I got back in my car for a very long, lonely drive back home. It hits me hard every now and then, confronting that I’ve only seen my son for a few hours over the last nine months, such as when someone asks for a recent photo…and I don’t have one.
At the PQ family program I attended last Spring, we were given a bean seed to take home. Well, I could just look at that bean every now and again to reflect on the program experience and learning, or I could put it to work. And as it turns out, it put me to work. So I got a little pot, some soil, planted the seed, and placed in on a south-facing windowsill where it reveled in the lengthening spring days. Around Mother’s day, when we finally got consistently above 50 degrees at night (I’m from Seattle…it takes a while spring to actually take hold in my part of the world), I moved it out to the garden–thinking of the exercise we did where we learned about transplanting. I carefully tended to the roots, and gently repacked the soil, and made sure it was well watered over the next few days (actually I didn’t have to do much external intervention in that department–did I mention I live in Seattle?), all the while thinking about my son and his recent transplant experience. I wasn’t quite sure what I would find when I picked him up at the airport, twelve weeks after I sent him to you. I know he had a bumpy time at PQ, but the person who emerged was like the kid I had once a long time ago–open, reflective, curious, not so defensive, and even a little optimistic. He had found a place, a tribe, acceptance. As we drove from to the new place, where he would start another, even longer program, he talked about feeling ok about himself–something he hadn’t felt in a long, long time. I had this rush of relief and euphoria, thinking that he had turned a corner, and that he was going to be ok.
Well, transitions can be difficult. Very difficult.
Everything progressed well for a couple weeks. Little Bean started to bloom. But one day some deer came through and ransacked my whole garden–tomato plants, raspberry buds, carrot tops, beets, leaves and buds on fruit trees…and Little Bean was taken down almost to the ground. I thought it was toast. But we had a two warm weeks afterwards, and it started to leaf out again. And then came June…also known as Junuary in Seattle. It got cold and rainy. Bean barely grew at all. But it was still alive.
Towards the end of June, it was just starting to get warm again, and Bean started growing. But then one morning I came out and… AGAIN. Chomped by deer. Just as it was starting to produce. Our dog has one job…ONE JOB—keep the deer away! Apparently he is no longer taking his job seriously. I didn’t have a picture before the attack, but Little Bean was bushy, about 1.5 feet tall, had blooms, and actual beans.
I started to realize that Little Bean’s struggles were another parallel process. So on June 24th, I started taking pictures of the deer-struction.
Summer arrived on July 5th (as it usually does). I had started growing pole beans on the trellises. Little Bean, it turns out, is a bush bean. This was a major contributor to its struggles as it couldn’t grow up out of the way of the deer. But Little Bean kept trying…until another deer attack, July 18th.
They denuded the pole beans of all the leaves along the trellis, but couldn’t reach those at the top.
So, as we approached the end of growing season, I realized (duh) my laissez-faire strategy wasn’t working. The dog was no longer effective as a deer-terrent and they weren’t getting full on the many other tasty treats in the garden. I had to try something different–Little Bean couldn’t grow indoors, but the out-of-doors wasn’t quite working out either. Enter the cloche. I use these to get tomatoes going early in the season. It finally dawned on me that I could deploy them against the deer.
With this protective covering, Little Bean grew a bit more, survived two more pillages, and on August 30th I harvested two small beans.
But then came the slugs: September 24
I deployed slug traps, put the cloche on at night and during rainy days, but here we are at the end of September, and realistically, I’m not going to be able to count on Little Bean to produce enough food to get us through the winter.
But there are a couple new blooms. Little Bean is still trying. September 29th:
Some takeaways– I need to improve the deer proofing of my garden. Little Bean was not the only casualty. Harvest was way down across all product lines. Next year, I’m enclosing the garden. The cloche did the trick for a while, but I deployed it too late in the season. However, Little Bean started getting too big for the cloche, so that solution wouldn’t have worked indefinitely. Then came the slug invasion. So the cloche couldn’t protect from all predation. I also realized that I need to plant the right kind of bean for my conditions. Pole beans do much better, not only in terms of surviving the deer, but they just get far more light in my garden configuration. If Little Bean hadn’t carried the additional burden of symbolizing much more and serving as proxy for the care I wanted to be giving my child, I would have given up and chocked it up to a poor plant choice and bad luck with the deer. But it was what you guys gave me, just as the universe gave me my particular kid. I kept at it, and looked for new strategies to help it survive. Another solid lesson is that it’s good I’m not a farmer and people don’t have to rely on me for their food supply. The small success story of the garden this year is the pole beans, which survived the repeated pillages and are now in full production mode. Here’s what I harvested today, and there’s still lots coming, even though the middle of the plants keep getting eaten.
The growing season is coming to an end, but fortunately, we humans can keep at it even during the winter months. Thank you PQ for all that you have done for our family…we are still growing though it hasn’t been easy. Thank you especially to Mark White who really stuck with my Little Bean.
Getting off the farm and out to explore the island is a big hit amongst PQ students. This past weekend, students of the young adult program travelled mauka to the Ka’u Desert, situated on flanks of Mauna Loa. The students enjoyed a great lunch, punctuated with views of the ocean, volcanoes, and indigenous plants and birds.
Three years ago I was known for running away from Pacific Quest on several occasions. Now I look back and see how far I’ve come.
I attended Pacific Quest at a very rough point in my life. I was suffering with several mental health issues as well as the aftermath of severe emotional trauma from childhood. I have anger issues, attitude issues, self and esteem issues.
Through the beautiful hearts and souls that comprise this program, from therapists to field staff, I healed from alot of early childhood issues, learned to love myself, developed coping mechanisms to cope with my mental health issues, and made meaningful connections that i never thought i could make. I also had a genetic test done that allowed me to find out the right type of medication I should be on.
Three years later, I left California and moved to North Carolina with my mom, where I have been pursuing horticulture and landscaping, with a deep passion of becoming a horticultural therapist down the line. I am a Certified Plant Professional through North Carolina Nursery and Landscape Association.
I still struggle with mental health and emotional issues, however, with the continued coping skills learned from PQ put into action such as meditation, journaling, exercise, gardening, and well as my own continued pursuit of counseling outside of PQ, I’ve created a life that is truly worth living. I finally have healthy friendships and relationships that I enjoy and feel joyful most days regardless of the circumstance.
One of my favorite quotes is that “people will only meet you as deep as they’ve met themselves”. I definitely met myself in a meaningful and often painful way at PQ, which in the life changed me and made me grow for the better.
Thank you PQ. When things are rough, I think of all the loving hearts that have pushed me to be my very best self and help me recognize the potential for a better life.
We are celebrating another year as a Gold Status Research Designated Program! The Pacific Quest team is dedicated to ongoing research efforts put forth by the University of New Hampshire and the National Association of Therapeutic Schools and Programs (NATSAP). Gold Status is the highest status granted by the NATSAP research committee for data collection rates.
PQ data indicates that a significant number of our adolescent and young adult students that graduate Pacific Quest report a reduction in clinical symptoms and remain below the clinical cut-off six months and one year post treatment. We utilize a normed and valid survey known as the Youth Outcome Questionnaire for adolescents and the Outcome Questionnaire for young adults.
We are grateful for every family that has contributed to our data collection efforts since we began this partnership with UHM and NATSAP in July 2014. We look forward to continued data collection using normed and valid measures and our continued contribution to the outdoor behavioral health research database.
Outcomes studies on wilderness therapy/outdoor behavioral healthcare (WT/OBH) programs serving youth ages 12-17 have demonstrated that family involvement in treatment increases the likelihood of long-term maintenance of individual students’ gains from such programs. This same body of research has linked caregiver participation in family activities to an increase in trust and empathy between caregivers and students. However, as some researchers have uncovered, these gains may not necessarily generalize to improvements in family functioning. Moreover, when considering family involvement in the treatment of young adults (herein referred to as emerging adults or EAs; ages 18-25) there remains the historical remnants of a socially constructed bias against such involvement; based on the presupposition that the paragon of EA development is “independence” from caregivers.
Pacific Quest’s Family Program for Emerging Adults
At Pacific Quest (PQ) we have considered the above research findings and social constructions, and in response have developed our Family Program for Emerging Adults based on a practice-based evidence/research model. Data from our practice suggests not only is family work with EAs appropriate, it can often be a critical element of their treatment process as caregivers report a correlation between our Family Program and an improvement in family functioning. This has led us to conclude that the ultimate aim in the treatment of EAs may not necessarily be to only encourage greater independence, but also to cultivate intentional interdependence.
Clinical and Theoretical Foundations
PQ’s Family Program for EAs is embedded within an integrative WT/OBH model designed to treat a variety of emotional and behavioral problems by way of horticultural therapy and other experiential modalities. Our Family Program for EAs builds on this model by creating opportunities for corrective relational experiences (CREs); unexpected moments when caregivers and EAs are able to attune with one another and are therefore transformed. During these CREs caregivers and students learn in what ways they mutually influence one another and thus how to be intentional with that influence. The nature of human nature is that we are not independent, but rather are reliant upon each other. Through intentionally designed CREs, family’s at PQ become more cognizant, and thus able to influence this reality.
The Corrective Relational Experience Over several years of observing Pacific Quest’s Family Program for EAs, we have come to understand that while there are a number of smaller CREs throughout the two-day intensive program (consisting of caregiver-only meetings, family therapy with primary therapists, and multi-family therapy groups) the overall Family Program is itself a CRE. We have found this CRE to consist of two primary clinical dynamics: Differentiation and congruence (see Figure 1): Development of one positively influences development of the other. Moreover, these processes mediate the establishment of accurate empathy and trust, which in turn can encourage the maintenance of differentiation and congruence.
Improvements in Family Functioning
PQ’s Family Program for EAs has been correlated with improvements in family functioning. This has been measured through a pre/post-test design employing the psychometrically supported Global Assessment of Relational Functioning (GARF). The GARF consists of three subdomains:
Of 161 caregiver respondents, all reported improvements in the three GARF subdomains (see Chart 1). Overall, the subdomain reported most positively impacted during Family Program was Emotional Climate. Communication (an aspect of the subdomain Interactional/Problem-Solving Skills) was identified by 85.7% of respondents as the specific aspect of family functioning most positively impacted by the Family Program.
At Pacific Quest we have answered the call from researchers to improve family engagement in WT/OBH. We have also recognized the interdependent nature of human nature and used this as the impetus for our work with EAs and their families. By employing a practice-based evidence/research model we have correlated our Family Program’s CRE approach with improvements in the emotional climate and communication aspects of family functioning. Future practice/research with EAs might consider how to generalize such improvements in family functioning by creating CREs with others (e.g., siblings or families-of-creation) and in other environments (e.g., a transitional program or a caregiver’s home).
I love the idea of “Farm to Table.” Eating at restaurants that take this approach is so satisfying – food right from the garden, even better when the food is organic. There is nothing quite like the crunch from a raw green bean that has been harvested that morning! While this dining option appears to be hip and trendy these days, farm to table is how our ancestors sustained themselves every day.
Living in Hawaii, where food grows abundantly, I got to thinking that it would be a healthy challenge to see if I could pull off the “Farm to Table” lifestyle. So I planted, replanted, weeded, pruned and harvested. I repeated the cycle and repeated it again and again. After about a year I’m proud to report that I’ve achieved a seventy percent failure rate on the food I’ve planted. Consequently, I do eat thirty percent of my food from my garden, which I consider a mild success. I am still mostly a ‘Safeway to Table’ guy at this point (which is fine because they give fuel points and gas on the Island is expensive).
So why am I proud of my seventy percent failure rate? Because I learned I need to keep planting. I learned that “Farm to Table” is, in fact, all about resilience, perseverance, and practice. If I choose to focus on the seventy percent failures, then I will be unlikely to plant. If I choose to focus on the thirty percent yummy goodness from the garden then I’ll be more likely to keep planting.
I’ve also learned that I can be resilient and strong in this way
– like my ancestors. So I choose to keep planting.
I strive to be as skilled as they were and I will enjoy the vast majority of my
food from my garden. I have to persevere in my planting, struggling and
This past year, I have been particularly inspired by the effort and growth of my Pacific Quest students. Witnessing their journeys of self-discovery, personal strength and resiliency is reaffirming and heartwarming. Our alumni substantiate that their personal development at PQ is easily transferrable to life on the mainland. The awareness, skill sets, and confidence our students develop are indeed sustainable. Our students clearly know what ‘keep planting’ means, in their own, unique ways.
In addition to his extensive clinical
background prior to his work at Pacific Quest, Mark served as Director of
Clinical Quality for an integrated healthcare agency. Mark also holds a masters
degree in School Counseling and has a breath of professional experience as a
teacher, school counselor and Head of School. Mark holds a deep sense of
learning styles, learning differences, and student engagement strategies to skillfully
help young adults effectively utilize their learning preferences to advance
their personal growth.
Mark is dedicated to supporting emerging young
adults in their recovery from behavioral health issues including anxiety,
depression, isolation, and problems related to substance use. Mark utilizes a
variety of therapeutic approaches that include a solution-focused framework,
Jungian depth psychology, ecopsychology and earth-based healing, rites of
passage, and Dialectical Behavior Therapy (DBT). He has training in the Hakomi
method as well as EMDR, which he continues to develop as part of his practice.
Mark believes Pacific Quest combines
innovative best practices and evidence-based standards to a degree of quality
that is virtually unmatched. Mark is honored for the opportunity to promote and
facilitate change in the lives of clients and families accessing care at
Mark enjoys fishing, hunting, being on the
ocean, teaching, and growing food. When he’s not in the garden working with
students, he is exploring the beauty and dynamic landscape of Hawaii Island
along with his wife and daughter.
“Mark White was an extraordinary therapist for our family. He
guided all of us in a clear, caring manner and we will be forever grateful to
“Mark has been excellent! His communication has been wonderful.”
I remember my first job out of graduate school, working in a psychiatric inpatient facility, and listening intently as nurses and doctors spoke about the patients with whom we were working. A patient in particular sticks in my mind, a young adult female who had been in and out of our facility ten times in the past two months, who loudly exclaimed her self-harm for all to see and hear. The stigma of Borderline Personality Disorder (BPD) that I witnessed some twenty years ago is still with me. Since that time, I have revised how I think of people who present with these symptoms and with this diagnosis, realizing how these behaviors do not define them, but rather how they are an expression of fear, of pain, of vulnerability, and of anxiety.
An article, that many of you may have seen, recently floated across Facebook: “We need to treat borderline personality disorder for what it really it is – a response to trauma.” I was intrigued and as I read through the comments posted prior to the reading the actual article, I realized just how much the stigma of BPD hasn’t actually changed in the past twenty years. I still hear parents gasp with shock and fear at the mention of BPD traits.
Let’s forget the Facebook article, that while true and accurate, isn’t actually a credible source and instead examine scholarly research. A study by Bandelow, et al, (2005) indicated that those diagnosed with BPD had a statistically higher rate of early childhood trauma than the control sample. These traumas ranged from abuse and neglect, parental separation, childhood illnesses, medical trauma, unhealthy family systems, etc. Premature birth was also noted as statistically higher for those diagnosed with this disorder. This is one of many research articles making this link.
In practice with adolescents and their parents, those presenting with borderline traits consistently have a history of trauma and as they describe the symptoms we are so familiar with (poor ego strength, instability in functioning and achieving goals, impairment in relationships, frequent mood changes, separation insecurity, anxiety, impulsivity and/or risk-taking, and hostility), they talk about really wanting connection, to feel safe in relation to others, fearing rejection and abandonment, and having big emotional responses to small situations that they don’t understand any more than the next person. Sometimes, I hear stories of a big Trauma and other times I hear stories of little traumas that accumulated over time. It may be that there were dozens, maybe hundreds of little emotional betrayals and hurts that added up and derailed a child’s ability to trust someone with their care. They described the need to be impenetrable and safe while simultaneously tormented by the human desire to feel closeness, created the push/pull dynamic that friends, families, and therapists are so acutely aware of.
The Facebook article is right…it is time we recognized BPD as a response to trauma. Rather than focus on the very difficult symptoms to manage, recognize the strength being presented to you in their ability to survive. Recognize that inside the layers of muck, there is a precious human being desperate for safe connection. With this new formulation of BPD at hand, we also have to look at how we treat BPD. Ultimately, we have to approach treatment from a trauma-informed lens, one that aims at healing, providing reparative experiences, and teaching healthy attachment. To do this, we must focus on emotional regulation, emotion tolerance, debating negative self talk, building ego strength and finding ways to celebrate success; all in the context of healthy relationships being role-modeled and the clinician providing a safe, non-judgemental space to hold what is present and return it back to the person in a form they can digest in order to heal the relational trauma of the past. Only then, will a person be able to move to a place of accountability, examining unhealthy relational patterns, and work on their ensuing identity crisis as the “get better.”
Ultimately, what a client who presents with these symptoms needs from their treatment team is compassion and the unwavering ability to see through the unpleasant layers of protection they have covered themselves in. Or, in the words of the late Dr. Karyn Purvis, who specialized in relational and developmental trauma: “It is powerful for [people] to know that they are loved and adored even in the midst of their worst behaviors.”