When we updated the Heritage review in 2014, we wrote, "If you have not seen Heritage in the past year, you have not seen Heritage. Or perhaps if you haven't seen Heritage in six months, what you would see today would be very different from what you saw previously." The changes and improvements continue. Once a very generic program for virtually any kind of emotional challenge, Heritage now focuses on specific issues. (More about that farther down this page) Heritage was once a facility that seemed to struggle with a confusion of identity. While Heritage always valued relationships in healing, a behavioristic culture and sometimes actions that seemed unnecessarily punitive would surface. You will not find significant punitive/ behavioristic influences now. At one time Heritage was criticized for allegedly poor psychiatric (psychopharmacology) coverage, but whatever might have been a valid criticism then, structures put in place in 2015 have enabled Heritage to set a firm standard and we no not anticipate valid concerns of that kind in the foreseeable future.
If you have past history with Heritage, we want to say with great emphasis, any opinions and impressions based on observations prior to 2013 are virtually irrelevant. Many important improvements occurred after 2013, so you may still need to do some updating regarding understandings from 2013-2016, but the real cultural shift occurred 2013-2014.
Before we go further here we must disclose potential perceived conflict of interest. Our consultant, Tom Croke, served on the marketing staff at Heritage from 1990 through 1992. That was a long time ago and he did not hesitate then or more recently to challenge Heritage when it failed to adhere to the relationship based treatment identity that it they hoped to achieve. But Tom's historic connection still needs to be disclosed. We do have more information here than on other programs we have reviewed, because we know it better and know more about it. Also until the time Jerry Spanos came out of retirement and returned to the CEO position at Heritage, we would not have written a review this enthusiastic. We think prior to his retirement then return to the fray he was less insistent on full acceptance by his middle managers of his commitment to relationship based therapeutics. Be that as it may, we certainly liked what we saw of Jerry then and even better now. Even when we did not agree with Jerry, we always believed that the decisions he made were what he believed were the choices that were the best for the young people Heritage was treating.
- Top of this Page
- Notice of conflict of Interest
- Charitable Program
- Therapeutic Supports
- Physical Plant
- Extracurricular Activities
- Personal Observations
- Bottom of Page
Heritage is a true not-for-profit program. We use the word "true" because many programs that carry a 501 (c) (3) tax exempt status, as does Heritage, are still dollar driven, just as many smaller (usually the Mom'n'Pop variety) are legally profit making but always willing to defer profit in order to help a child they serve. Heritage is a not-for-profit legally and practically.
Why do we put this at the top of this page, where readers might expect concrete information about therapeutics? Because the charitable spirit at Heritage permeates everything that happens there. Details about the program should be read in that context.
Founder and CEO Jerry Spanos created Heritage based on his dream of a facility that produced therapeutic breakthroughs with difficult kids by the power of quality relationships. In 2016 "relationship based" is a common buzzword; Jerry was all about relationship based services in the 1980s or before, when everyone else was either into psychoanalysis or "break them down" methodologies. In fairness he had trouble getting "relationship based" fully implemented at times past but it was always his goal. He had retired at one time as CEO of Heritage, remaining on the board of Heritage, but came out of retirement without salary when he discovered that the program was not living into its stated values.
Heritage operates (2016) at lower charges than most other programs with similar or lesser services and have tools at hand that other programs tend to lack regardless of what they charge for services. This is because of the generosity of people who believe in the mission and Jerry's interaction with those people. Heritage has used its status as a charitable organization to raise money for specific projects and has been extremely successful in securing very substantial amounts of money -- especially in recent years. This leads to programmatic improvements without increased charges. For example, the theater was built with donated money, as we understand it, mostly from a single donor. The million dollar grant to refurbish buildings (and build a few new ones) is another example of this. (See below regarding theater and building program) Heritage's culture would not permit it to sacrifice a resident's best chances for full recovery in the interest of capturing or saving some extra dollars. Back to Contents Back to Top of Page
Heritage divides into eight gender and diagnosis specific "programs within a program." They divide into "Peers Academy" program for tweens and teens with social challenges and "Elevate Academy" for neurotypical tweens and teens with mood and anxiety disorders. Each of these has its own clinical director, its own residences, and its own therapeutic staff and milieu. Each of these further divides by gender (now we are looking at four distinct programs) and again by age (now we are looking at eight distinct programs). Those younger than fourteen are grouped together and those older than fourteen are grouped together in both Peers Academy and Elevate Academy. Fourteen year olds might be in either age group depending on judgments made at the time. In addition, Heritage has recently (October 2016) opened Launch Academy, which might become "program within a program" numbers 9 and 10.
We are especially pleased to see the upgrading in psychiatric service on the campus. Heritage has contracted with a medical group that provides a psychiatric nurse practitioner for a level of time commitment that is the equivalent of a full time employee. This gives her the opportunity to participate in treatment planning for all students and to know the students for whom she is prescribing and otherwise providing care. She accesses consultation from one or more psychiatrists when necessary. Replacement coverage is also provided when she is absent, such as vacation, conferences, etc.
At FamilyLight we welcome programs choosing to engage a full time physician assistant or nurse practitioner to provide psychiatric care in preference to very part time psychiatrists. We think opportunity for consultation with one or more psychiatrists is important in these situations; that is provided here. We like the fact that this is on a contract basis with a group that provides backup in case of absence.
Peers Academy includes tweens and teens with challenges that revolve around social skills. This would include autism spectrum disorders, Nonverbal Learning Disorder, and others without one of these specific diagnoses but clearly challenged socially. Peers Academy is informed by the Program for the Education and Enrichment of Relational Skills at UCLA (PEERS) and is engaged in joint research with that group as they apply principles of the original PEERS program to a long term residential treatment setting. The PEERS program as it is practiced at UCLA (a short term program as practiced at UCLA) is a strongly evidence based program, a fact that we find particularly interesting in light of the the extravagant and self serving claims by some promoters of ABA that they are the only research based approach to ASD children. (See more about this issue in an article devoted to that topic) The application of the principles of PEERS to long term residential treatment is currently a subject of ongoing research in a collaborative effort between Heritage and UCLA. 53 of Heritage staff members had been certified by UCLA in PEERS methodology at the time of our 2014 visit. (Please note that the inconsistency on capitalization is intentional. "PEERS" as the name is used in the original program at UCLA is an acronym as shown above. As Heritage uses the name it is obviously influenced by the UCLA acronym but the name at Heritage is not an acronym, "Peers Academy" is the full name of the program at Heritage.)
In August 2016, Heritage announced the opening of an Autism Sensory Center. This is a giant step toward making Peers Academy at Heritage one of the pre-eminent autism treatment programs in the country. More about that down this page. Back to Contents Back to Top of "Clinical" Back to Top of Page
Elevate Academy is for neurotypical tweens or teens with mood and anxiety disorders. In the older group (age 14 and up) Heritage appears to be fairly rigorous about limiting enrollment to those with those specific issues. This means Heritage is no longer a general mental health offering for any adolescent with mental health needs. However, we perceive greater flexibility with diagnoses in the younger group. They have some openness to Oppositional and Defiant Disorder (ODD) and extremes of ADHD especially among the younger group there. In the older population (ages 14 and up) a person who is primarily ODD or Conduct Disorder probably does not belong at Heritage. In the younger group, this population is approached with great caution but with some flexibility. Back to Contents Back to Top of "Clinical" Back to Top of Page
Launch Academy is currently (October 11, 2016) being phased in. This is a transition program based on the Heritage campus. An Eight Bed dormitory is now open for boys. A similar 8 bed dormitory for girls is projected to open early in 2017. This offering will expand gradually. Heritage participants age 16 through 19 who have had at least six months successful participation in the Heritage program or successful completion in another program. Support remains available for mental health issues as needed but the emphasis is on life skills of adults in a much less restrictive setting. Back to Contents Back to Top of "Clinical" Back to Top of Page
Heritage is quite firm on the separation between neurotypical and socially challenged. This does represent a recent change. At the time of our 2014 visit, the division between Peers Academy and Elevate Academy applied only to the older teens' programs. Ages fourteen and under were in a combined general mental health milieu. Peers Academy and Elevate Academy have very recently (June 2016) been separated from each other at all age levels and each is now headed by its own clinical director.
On our visit in November 2014, we focused on determining whether the relationship basis of therapeutics had truly replaced the previous sometimes reliance on punitive behavioristic methods. We found that they had. We expected improvement on this. We were not expecting the thoroughness with which this transition had been completed.
Some will recall the time that Heritage was largely populated by very tough kids, many having severe Conduct Disorder headed toward Antisocial Personality Disorder. Those kids do not belong at Heritage today and Heritage will not knowingly accept them at this time. Back to Contents Back to Top of Page
We list here services that are clearly in place to enhance clinical effectiveness and are themselves clinical in nature. However they are not at the core of the individual clinical activity. Back to Contents Back to Top of Page
Historically, Heritage has not claimed that Attachment Disorder and Attachment issues are one of their strengths. Recently (November 2016) they added an "Adopt a Horse" program to strengthen their ability to work effectively with attachment effectively. Historically, Heritage has been well skilled with developmental object relations. This relates well to the needs of children and teens with attachment issues. For long time Heritage accepted kids with known significant attachment issues only when that was regarded as a complicating factor with another diagnosis and then only on a case by case basis. In addition, Heritage (and probably every other therapeutic facility) would discover serious attachment issues only after the child in question was already there, being treated for some other kind of mental disorder. In those cases, in some cases they would recommend a different facility; in others they would continue with that child doing the best they could.
We applaud the addition of the "Adopt a Horse" program, but we do not think that single change makes Heritage the world's leading institutional expert on attachment. But the basic building blocks are in place: relationship based facility; provision on property for more intensive care for young for people in crisis; well developed equine program, etc. We hope to see Heritage in the forefront of attachment therapy in the foreseeable future. This is a great step in that direction.
To understand Sensory Integration we suggest the article linked here.
In August 2016, Heritage announced the opening of an Autism Sensory Center which it describes as a "First-in-Industry" resource for students in the Peers Academy with Sensory Integration issues. We understand that children with Autism Spectrum disorders, Nonverbal Learning Disorder, and other conditions which impact social skills are the most at risk to be impacted by sensory integration issues. So placing the sensory integration resources within Peers Academy does make sense. However we understand that that otherwise neurotypical children CAN be impacted by sensory integration issues. Could an Elevate student access these facilities? We don't know.
We were initially concerned with the "First-in-Industry" claim, as we have seen rather impressive such facilities, perhaps the most impressive being at Monarch Center for Autism. We challenged Heritage on this. They replied that fairly elaborate sensory integration facilities do exist elsewhere but not as elaborate and well developed as this. We agree that the facilities of this kind that we have seen are essentially a single very well equipped room. Heritage's is multiroom and with more being offered and more opportunity for residents to use these facilities simultaneously without interference with each other. We have great faith in the honesty of the Heritage team in reporting on matters of this kind and agree that we are unaware of other multi-room facilities of this kind. If any readers who have seen the Heritage facility and know of other truly comparable or more elaborate facilities that pre-date this one, please let us know, preferably by leaving a comment at the bottom of this page. This is, in any case, a huge step forward in providing resources for the Peers population. Comparable resources for this population are quite rare. Back to Contents Back to Top of "Clinical" Back to Top of Page
Another addition to the Heritage menu of resources is the Adventure Therapy program for their Elevate Academy. Heritage is not a wilderness program but does include wilderness type experiences in their range of opportunities, especially for their Elevate Academy students. Quality adventure programming is not unique to Heritage, although we we have been impressed by Heritage's YouTube presentation of their program. This type of programming is probably the most effective tools in helping young people to overcome irrational fears and self-doubt. Back to Contents Back to Top of Page
Heritage has been considering enhancements to its end-of-treatment transition options for its students for months. Individual therapists have historically worked with each student according to perceived needs, but there has been no specific program component designed to work with all planned discharges following a uniform protocol. With the introduction of Launch Academy, some of their plans are coming into fruition. This is a giant step forward in one of the few weak spots remaining at Heritage. This will provide an opportunity for some students to begin the process of adapting to "real life" while still at Heritage.
Heritage has the most sophisticated Chaplaincy Program we know of in any nonsectarian program based upon private funding, supporting religious development in the faith of the family sending the student and supporting the dimension of spiritual growth in the healing process. (In fairness, we need to mention that Yellowstone Boys and Girls Ranch has a comparably developed spiritual development program that is organized differently but is also quite sophisticated and supportive of all faiths. Yellowstone is a therapeutic program we admire. They are open to private pay clients, but most of their clients are publicly supported.) This program at Heritage is elective but the majority of students at Heritage are very willing participants.
We will be quite blunt here. We are confident that what we write will be offensive to some, but we believe it needs to be asserted. Most programs, inexcusably, justify avoiding religious issues entirely with the protest that they can't support religion in any form without seeming to favor one religion or another. Or if that protest does not work, the fallback position is usually "you can't capture the interest of this age group in religion." What Heritage is doing with this proves both defenses to be simply wrong. At Heritage religion is not forced on any student. But when spiritual matters are presented by dedicated competent people, most adolescents will choose to get involved. See also Religion, Family, and Spiritual Dimension of Healing. Back to Contents Back to Top of Page
School at Heritage is operated as close to a typical middle school and high school as they can make it, except that classes are gender specific. Two of Heritage's buildings are exclusively school buildings, one for boys and one for girls. The school faculty takes academic achievement very seriously, not just something to "get out of the way" so they can attend to other priorities. College bound students will encounter academic challenges appropriate to that situation including available AP courses; students needing learning support in order to succeed academically will get that, too. Elevate and Peers students share classes at Heritage. However Heritage management is observing and further evaluating this. They tell us they will separate the students by program if they see indications that separation would better serve the needs of those students. College bound students will find the courses at Heritage to be excellent preparation. Back to Contents Back to Top of Page
The campus gives the appearance of a village at the end of a dead end street, with a series of residential buildings that look like large private homes, a theater capable of presenting a Broadway production, a barn and indoor riding arena for equine therapy, a gymnasium, an indoor swimming pool, a totally new cafeteria for meal services, two school buildings, a clinical building, and an administration building. Abutting these buildings are large athletic fields. Residence buildings are designed to look like private homes in an affluent neighborhood. Arguably this is the very best physical plant for creating a normalized on campus environment in any RTC.
Heritage received a million dollar gift in 2014 (or perhaps a year or two prior) to renovate and expand the campus, and has used that wisely. This has resulted in the opening of at least two completely new residences, the total renovation of the interiors of almost all the remaining residence buildings, firm plans to renovate the residences not yet renovated, and the elimination of “temporary” (for many years) additional housing units downstairs in buildings that were created for additional residence space. Each residence houses approximately ten students, although they are licensed for 12 to 14 per residence. From what we could see on our visit of November, 2014, the resulting physical plant will be among the best that we see anywhere for a highly clinical program without locked doors if that benchmark has not already been achieved.
Actually we can think of no other program, RTC or therapeutic boarding school, with a physical plant of comparable quality, and/ or with as much attention to on-campus normalization. We do know other programs that are deeply invested in normalization through interaction with the surrounding community. It is very difficult to provide a fair comparison on the matter of normalization between Heritage and the programs that take that approach (see Crossroads Academy and Logan River Academy, as examples). Back to Contents Back to Top of Page
Extracurricular activities at Heritage are comparable to what we see in suburban public schools. Student Council, Student Newspaper, Intramural and Interscholastic sports, for example. To the best of our knowledge, only two Utah RTCs at this time (July 2016) offer interscholastic sports, Heritage and White River Academy.
It has a theater (and extracurricular drama offering) that could accommodate a Broadway show (and Heritage presents at least one major production annually). The existence of the theater puts Heritage into a very special category in several ways. First it offers exposure to cultural resources that simply could not happen in any other RTC with which we are familiar. It offers students an opportunity to participate in a drama program that is unlikely to occur anywhere else in a therapeutic environment of comparable clinical capability. Back to Contents Back to Top of Page
The manner in which the program at Heritage is “normalized” makes it over-all possibly the most normalized residential treatment center (RTC), with respect to on-campus experience. Our prior version of this review said "It is the only RTC we can think of (please correct us if we err on this) with interscholastic athletics plus a very extensive intramural athletic program, and a range of other co-curricular activities and recreational opportunities." Until today (June 20, 2016) we expected to leave that statement intact as we revised and updated. But we received an email today from White River Academy telling us they have introduced interscholastic league athletics. That is a very different kind of program, not so much normalized, but it holds an RTC license in Utah. So there is at least one other RTC with interscholastic athletics.
Because Heritage is so self sufficient with its internal resources that it has less need to involve its students in resources of the surrounding town, it does not provide as much opportunity for such activities as some other programs. We would encourage Heritage to examine this and consider create more opportunities for school, employment, volunteer opportunities and recreation interacting with people outside the Heritage community. Back to Contents Back to Top of Page
These are specific examples of what Tom saw and heard that leads to our confidence that program is truly relationship based and the concerning punitive procedures have been discontinued (these examples are written in first person, Tom writing):
- I spoke with about two dozen students. Incredibly only one said he did not want to be there, and even he said that he appreciated the caring that is consistently demonstrated both by front line staff and his therapist. I observed the same boy discuss with Jerry Spanos a concern he had about his privileges. This demonstrated Jerry Spanos' accessibility to the students, and the way student concerns can be heard. It further demonstrated that privileges are based upon what the students can handle appropriately and not locked into a rigid system that is part of a behavioristic levels system.
- Each student I spoke with, with whom the issue came up, spoke highly of their experience with both therapists and front-line staff. This has not happened on previous visits, where historically, at past visits, students had been broadly critical of the front line workers.
- Those who had been at Heritage for more than six months (this was 2014) were, in all cases, outspoken about the changes that had been put in place since they arrived. It was clear that they would not have spoken so highly of their experience if I had asked six months ago. They were all very cognizant of the process of change that is still happening. This demonstrates a process in place that that is obvious to the students.
- I asked most of the students I interviewed: "If you could change one thing about Heritage, what would it be?" Most of the responses were trivial. A few involved requests for more privileges. They knew what they needed to do to get the privilege at issue. A very few mentioned food service (Imagine teens wanting better food). Nothing like the responses to that question from a few years back.
- A girl who had just arrived within the past 24 hours was refusing to participate in any way. Early in my “roamings” some girls from her house went to her and said “we need you for our team. Please come help us win.” (A tournament of intramural athletics was underway) The girl went off with them and participated in an intramural sport – I don’t recall which one. I think it was soccer. But when the game was over she was back into boycotting. A staff member came to her and asked about what she liked and discovered the girl had an interest in horses. As I was wrapping up my time at Heritage, about 5 PM, the girl was in the horse barn with that staff member getting acquainted with the horses and deciding which one she wanted to become “her horse.” Historically, that kind of resistance would have resulted in her going to the punitive “Intensive Support Program.”
- In the "old days" I was never quite comfortable with the "Intensive Support" areas. They were perceived by the students as punitive, depended heavily on isolation, and were sometimes used in ways that appeared to serve punishment purpose. As I toured those areas, I saw a total turnaround.
- When I was there they had no "customers" in the girls' "Intensive Support" area. (I can remember a time when it would have been unrealistic to expect to find either of these areas empty)
- Three boys were "patronizing" the boys' area. Two of the boys were enjoying themselves playing a card game with each other. A staff member was informally chatting with them as the game proceeded. These two were among the boys I spoke with. They were not negative about being at Heritage and not negative about being temporarily in that specially structured location. I did not ask if they were volunteers or conscripts for the special location but they clearly did not mind being there. The space was obviously set up to make it attractive to students feeling a need for special attention and support without being punished.
- I did not get a sense of what was happening with the third boy who seemed just not to want to be disturbed. But all three were in the large room – not in the small side rooms that were once used for isolation.
- Jerry Spanos said that they need to develop their sensory integration resources and that would happen in the near future under guidance of their Occupational Therapist. (remember this conversation with Jerry occurred in 2014) Jerry said the SI devices that they do have are very popular but I did not see them in use. In August, 2016, that promise from Jerry became reality.
In our opinion, Heritage has created one of the most comfortable venues for a therapeutic environment for adolescents. Its clinical and academic services are excellent. Most important, the facility has been on a continual trajectory of improvement for the past three years (written in July 2016) and there is no sign that they will become static. When we say "comfortable" we do not intend to demean either the clinical or academic excellence of the facility. The incorporation of a full time psychiatric nurse-practitioner into the treatment teams is a giant step enhancing the clinical depth, in a way that very few therapeutic programs do. Back to Contents Back to Top of Page
A Rating (we anticipate raising this to A+ when an anticipated upgrade in transition services occurs)
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Introduction to Heritage Review (public access)
Religion, Family, and Spiritual Dimension of the Spiritual Dimension of Healing
Return to Reviews and Discussion of Individual Schools and Programs (public access)
Archived Old review in old format (does not fairly represent Heritage as it is today)
Last updated December 15, 2016