Mateo's Experience Leaving Residential Care: Systemic Constraints as Obstacles to Placement

Abstract

Sometimes we encounter a case where the more we do to create or support change, the more the situation remains intractable. This article explores the notion of systemic constraints as a confound to treatment progress and uses a case example of transition planning for an intellectually disabled/mentally ill 20-year-old male residing in a residential treatment program as a means for examining this concept. A multileveled systemic perspective is applied to analyze the contribution of various constraints on the progress of the case. Lessons to be learned from this case are elucidated. They include (a) the importance of and guidelines for thinking in a multileveled systemic way when dealing with clients involved in numerous service systems and (b) the value of professionals exploring their own constraining impact on a case.

Keywords:

• adolescents
• multisystems
• treatment impasse
• residential care
• placement