A second stab at a solution

I had a meeting at Big Guy's school today. It's a beautiful place, an enormous change from his former inner-city cinderblock school, which came complete with concrete yard and chain link fence. Here there are 110 acres of grass, orchards, and woods. It's therapeutic just to be there.

The school is run on the sanctuary model, which emphasizes nonviolence and learning to self-regulate behavior. It recognizes that what is helpful to one child is not necessarily helpful to another. Some kids, for example, find it soothing to talk when they find themselves slipping out of control. Big Guy usually escalates when you try to discuss anything in the middle of a crisis. A bit of time to himself, especially outdoors, is more effective. Each child has an individualized 'safety plan' which includes steps to take within the classroom if he starts slipping into crisis, and steps he can try outside the classroom if the first attempts fail. All staff who interact with him are required to know what it is. This works a heckuva lot better than the one-size-fits-all behavior mod approach at Big Guy's old school, which pretty much amounted to getting brownie points for good behavior and having burly guys haul you off to a windowless room if you fell apart.

Today we discussed scaling back Big Guy's school day to reduce his stress load, so it's possible for him to be successful. This has a number of advantages over partial hospitalization: familiar surroundings, familiar people, and an easier path to full re-integration in the school day. 

We came up with a series of interventions that we hope will work. Big Guy is scared, but thinks he can handle it. He is determined to stay out of the hospital. Tomorrow he returns to school. I'm proud of him, and of the way he's handling all this.