DRUG PROGRAM BRINGS HOPE HOME

Treatment Plan Places Troubled Teens With Host Families To Learn How To
Live Clean And Sober.

Brian Wilsker cursed and grabbed and swung at his parents.

The 15-year-old had just learned he was being admitted to Pathway Family
Center, a long-term treatment program for adolescent drug and alcohol
abusers, in the summer of 2001.

"It was the hardest thing. For a month I was in a daze," said Flora
Wilsker, who acknowledged that she and her husband, Ken, had been in denial
about their son's marijuana use for years.

"I felt ashamed, sad beyond words. Scared. It was a horrible feeling."

Though Brian had been a drug user since middle school, this was his first
time in something very much like a residential treatment program. His
parents admit they lied to him about the purpose of their visit to Pathway
just to get him through the door.

Today, Brian says he knows his parents did the right thing by him.

"I enjoyed getting high in the beginning," he said. "When my disease took
control of me, the highs weren't enjoyable anymore. I just felt hopeless
and depressed all the time. Then I would use the drugs to cover up those
feelings. It was a cycle."

The Wilskers made an unusual choice in picking Pathway.

This is no locked-down psychiatric hospital or a wilderness camp in some
exotic location where children overcome grueling obstacle courses and the
counselors are as tough as drill sergeants. Although Pathway incorporates
the same kind of strict regime that many residential programs do, Pathway
clients stay in the homes of other participating families on evenings and
weekends instead of in a group facility. The children rotate between host
families weekly or even semi-weekly, and can stay with their parents only
for short stints after they've gotten past the first of five treatment levels.

The participating families have their own learning curve: They have parent
meetings, which are a kind of support group, every Monday and Friday night,
and each adult is assigned a clinical therapist they must see regularly.
Like the children, they work their way through five levels of treatment.

Started locally in July 2000 as an offshoot of a Southfield, Mich., program
that began in 1993, Pathway's centers are two of just three programs in the
country known to use host families in this way. A Cincinnati-based program
called Kids Helping Kids uses a similar approach but is not a Pathway
affiliate.

The Indianapolis center is a private, nonprofit organization run by
administrators whose own children have overcome substance abuse problems.

It's a little bit like student exchange and a little like foster care, with
a touch of Sen. Hillary Rodham Clinton's "It Takes a Village" philosophy
thrown in.

"They are very dedicated, very committed, very persistent," said Judge
James Payne of the Juvenile Division of the Marion Superior Court, who has
referred several families to Pathway. "They're willing to take kids that
virtually everyone else has given up on."

The Indianapolis center is too new to have complete outcome studies
available, but a study of graduates at the Michigan center found that 82
percent were "clean and sober" and 88 percent reported "improved
relationship with parents," among other positive results, up to three years
after completing the program. Outcomes compared favorably with the best
residential treatment programs nationally.

Twenty youths are in Pathway in Indianapolis, two-thirds of them boys.

Strict rules in the suburbs

Recently, the Wilskers, who run a nutritional supplement business, were
hosts to Matthew Van Horn and two other boys in their two-story brick home
in Fishers. That same weekend, the Wilskers' son, Brian, was staying with
three other boys at the home of Mark and Marie Van Horn on the Far
Southside of Indianapolis.

All the doors in the Wilsker home have alarms, and Flora Wilsker wears a
clutch of keys around her neck for various locked drawers and rooms in the
house. The youths, ages 16 through 18, are never allowed in a room alone.
They don't have TV or radio privileges, either.

They can't go to their bedroom until 9:30 p.m., and then only to sleep. The
stark bedroom has only mattresses on the floor and a jury-rigged doorbell
the children have to ring for permission to use the bathroom during the night.

The youths' time at home is spent doing homework, writing entries in logs
chronicling their recovery, and participating in discussions with the host
families.

For the parents, the program means being on duty 24/7 on the days they are
hosts to children, which averages out to about two weeks each month. Ken
and Flora Wilsker have no problems with that.

"Being able to see the changes that these kids have been through, to see
these other kids without the drugs and alcohol, gave me hope," said Ken
Wilsker.

"I always wanted more children. Now I have 19," said Flora Wilsker,
referring to the number of children to whom she has been host in recent
months, including some who have gone through her home several times.

Sitting around the Wilskers' living room, the boys tell of their descent
into the drug culture.

Mitchell Van Horn, a standout on the Southport High School basketball team
through his sophomore year, had been in drug rehab programs before, but
chronically relapsed. He recalled how before one drug screen, he drank 3
gallons of water, then vomited.

"That was a sign I hit bottom," he said. "I punched my dad in the face
once. That was another sign. There were a lot of signs."

Mitchell, 18, says he smoked his first joint four years ago, after a group
of friends said it would make him a "funner person."

"I turned down alcohol, though, because I didn't like it," he said.

Now in his 14th month in the program, Mitchell has attained the fourth
level, which means he has a few more privileges than the other youths. For
example, he gets to attend high school; most of the youths are restricted
to a tutor during the day inside Pathway's offices in a Castleton business
park.

Everyone is confessional; the Wilskers almost are equals with the boys in
their charge when it comes to discussing addiction, which Pathway teaches
is a "family disease."

One boy reveals that he was locked up "in juvenile" four times.

"I always thought it was a crisis because I couldn't use no more," he said.

Ken Wilsker smiles and nods his head when he hears that.

"I used to get a real charge out of rescuing (my son)," he tells the group.
"It was one crisis after another, and I would get a real rush out of that."

Later, he tells a visitor he was often frustrated by his son's drug use and
late hours. Sometimes he would lie in wait and argue with Brian when he
came home; other times he would just go out and get a drink himself.

Humor and Healing

Over at the Van Horn household on the Far Southside, Brian Wilsker was
participating in a similar group session with three other boys.

They talk about lying to their parents and being with druggie friends, but
there is some humor.

One boy, Jeff, says, "When I'm p - - - - - off, I think of a funny word,
like 'potato,' to calm myself down."

R.J., another boy at the session, laughs. "You should write a book, like
'The Art of Zen,' but instead of Zen it should be 'The Art of Potato,' " he
said.

In point of fact, the boys have been reading up on Zen and meditation as
part of their recovery.

Brian Wilsker is struggling to tell his story.

"First day, I gave everybody the finger," he confessed. "I was, like, 'Hey,
I'm not doing this.' I thought the idea of surrender was, like, 'I give up.
You're weak.' But it's not like that at all."

Brian says he used to fight with his father, and that his parents would
fight a lot over him. Living with other families was a revelation.

"I thought it was so weird, so fake, because you guys weren't yelling at
each other," he tells the Van Horns.

The young man shakes his head a lot when he speaks; it's like the old joke
that he'd been down so long he forgot what it was like to be up, he says at
one point.

But he's happy now, seeming to take pleasure in his own voice as he utters
the very word.

"Happy."

He says he's happy to be clean, happy to be reading books, happy just to be
for the first time in ages. The world looks so different to him now, he
marvels.

"You know what's changed?" Marie Van Horn offered. "You've changed."

Success hard to measure

Keeping drugs at bay, completing high school and going on to college or a
career and reuniting with one's family all are informal measures of a
substance abuse treatment program's success. Juvenile court Judge Payne
says he is very satisfied with outcomes so far.

"We sent a couple of kids to Michigan first and they did really well,"
Payne recalled. "They were a couple of kids we were close to giving up on."

But truly useful measures that can easily be compared between programs are
hard to come by, says Terence Gorski, a Homewood, Ill.-based consultant on
substance abuse relapse prevention and president of CENAPS Corp.

The weakest long-term residential treatment programs will show positive
outcomes in only 15 percent to 20 percent of clients, while the best will
show positive results in 70 percent to 75 percent, Gorski said.

However, he noted that outcomes can be inflated by using only readmission
to a facility as a sign of failure, by a low return rate on the survey
instrument, or even by doing the follow-up study too soon after discharge.

Gorski termed the Pathway program a variation of so-called "tough love"
programs combined with family-centered models. He says the best treatment
programs he has studied involve short-term in-patient care followed by
intensive outpatient and community-based follow-up, such as multiple
counseling sessions weekly, involvement in a 12-step program and
cooperation with school officials. (Pathway uses a 12-step approachbased on
Alcoholics Anonymous that emphasizes spirituality and personal
responsibility as part of its five-level program.)

He's highly supportive of the kind of family involvement Pathway encourages
but expressed some skepticism at using families whose own children have
slipped into substance abuse as hosts for other troubled children.

"It's not common," Gorski said, referring to the Pathway policies. "I would
label them as experimental modalities."

Other criticisms of Pathway exist locally. Payne says he's heard that the
program is too middle-class, though he calls that charge misguided. It
usually takes intact families or couples who are willing to work together
to make programs like Pathway succeed, he said. And because most Pathway
families pay their own freight, it's inevitable that most will be middle-class.

Rachelle Gardner is director of adolescent services at Fairbanks, formerly
known as Fairbanks Hospital, an inpatient treatment facility in
Indianapolis. Overall, she says, she is very impressed with Pathway and
notes that some clients who have gone through Fairbanks' crisis
intervention and inpatient programs have ended up at Pathway.

Still, she doesn't think the Pathway model can work for everyone.

"Sometimes (the children) need to be removed from that (family)
environment, to get their heads put on straight, then put back in the
environment," Gardner said.

Pathway costs about $30,000 a year, and a treatment program can be as long
as 15 months; insurance companies view the program as "day care" and
typically pay only a small portion of the overall cost, says President and
CEO Terri Nissley. Mark and Marie Van Horn, who work as a field service
engineer and in an insurance agency, respectively, say they took out a new
mortgage on their home and have had to forgo saving for their retirement,
at least for the time being. The Wilskers also took out a second mortgage,
terminated the lease on their primary vehicle early and sold some personal
possessions.

The program, which receives revenue both from fees parents pay and
donations, has operated in the black during its years of operation but
experienced a loss of about $40,000 for its last fiscal year due to the
establishment of the Indianapolis branch, said Nissley.

Both the Van Horns and Wilskers say any treatment program that works is
worth the price. Both families say they can now see the light at the end of
the tunnel -- Mitchell Van Horn recently applied to Indiana
University-Purdue University Indianapolis, and Brian Wilsker was able to go
home for the first time in eight months earlier in April. He didn't fight
with his parents at all.

"I'm the happiest now I've been in a very long time," said Flora Wilsker.
"Today I'm hopeful."