Go In-Depth

Placing your child in a Residential Treatment Center is an important decision for everyone. Here are some in-depth answers to questions many parents have about Residential Treatment Centers.

Can Residential Treatment Centers Really Help My Child?

Most Residential Treatment Centers are designed to provide your child with a therapeutic living environment to help your child develop skills to deal with emotional, psychological and behavioral disorders.  The children in these program require 24/7 care, go to school at the facility and participate in individual, group and family therapy. Many of these facilities transitioned from orphanages into treatment centers. Most centers include medication management, therapeutic treatment and appropriate schooling for children with severe mental and emotional issues. On-site psychiatric services are provided at some centers, but not all. There is very little research on effects of residential treatment on children. There is also little research on the effects of psychiatric medications on children. Each child’s issues are different. One thing is important; families must be intimately involved in their children’s care decisions.

What Should I Consider Before Placing My Child in a Residential Center?

The decision to place your child in a residential treatment center should be taken very seriously. These centers are designed for children who have serious emotional and mental illness issues that extend from school to home to community. You child will be in a program with other children who are also suffering from these issues. You will always want your child to be in the least-restrictive program that still offers the services your child needs. Utilizing an educational consultant will help you in this area. Look for a residential treatment center that is accredited. Also, you may want to utilize the COMPAS eval to better understand and articulate the complexity of your child’s needs to the center director or your educational consultant. If you have an adopted child, remember that you want to know if the center understands the particular needs associated with adoption issues.

What Types of Facilities Will I be considering?

Some facilities will be locked facilities; others will have an open door policy. It is not uncommon for your child to try and run away from residential treatment centers. Find out about the policy and procedures if you are placing your child in an unlocked facility.

What Types of Programs do the Residential Treatment Centers Provide?

Residential Treatment Centers work with the local school districts to provide modified classroom education. Children have a normal school day but also continue group and individual therapy sessions.
Accredited centers will provide psychiatric staff as well as psychologists and therapists. Therapy is offered daily and weekly. Therapy is usually provided in an individual, group and family setting.

What About Oversight of Residential Treatment Centers?

Some RTC’s will become accreditied nationally by JCAHO, other will join industry programs of National Association of Theraputic Schools and Programs (NATSAP) and the American Association of Children's Residential Centers (AACRC) which require programs to maintain a code of ethics and best practices. Only a few states monitor residential treatment centers, see RTC Laws for more information.

I Have Read About Violence at Residential Treatment Centers.

Violent or abusive treatment of patients is illegal. Each Residential Treatment Center will have a history and philosophy. There are RTC’s with outstanding reputations and some that have horrendous stories of abusing children. You will want to talk to everyone you can find in the mental health community to get information, utilize educational consultants, contact the state department of health and the better business bureau.  Make sure you completely understand the facilities' policies on restraint and discipline.

How Involved Should I be in My Child’s Treatment?

According to the Surgeon General and reported in AACRC research, children in RTC’s consistently have improved outcomes when parents and families are more involved. In the past, treatment tended to be youth centered with parents and family member access subject to much scrutiny. Many RTC’s are now moving to a family and community focus where applicable. The Federation of Families for Children’s Mental Health (www.ffcmh.org) defines family-driven care as: when families have the primary decision making role in the care of their own children including: choosing supports, service and providers; setting goals; designing and implementing programs; monitoring outcomes; partnering in funding decisions. Administrators and staff share power, resources, authority, responsibility and control with families and youth.There are centers that are very good but are less then open when you as a parent want to become involved. You must be prepared to work closely with the residential treatment center to make sure you are included in therapy as well as other decisions. Work out a visitation schedule every week. Make sure you understand the goals of the therapeutic work, so than when your child transitions home you both will be able to make the most of the new skills your child has learned.

What Happens When it is Time for My Child to Come Home?

From the first day, getting your child to the emotional and safety level so that they may move home is a very important goal. When you first admit your child, depending on the situation, you may not be emotionally ready to tackle this goal. It is important that the residential treatment center staff starts the process with you. While you have your emotional journey to walk, reuniting the family unit is always the end goal. When you get to the transition home process, it may be a very difficult time. Utilizing a wraparound or virtual residential treatment service where you have in-home coaching may be beneficial. Remember, your child is coming home from a setting where every minute was scheduled, where there was a breakdown of the entire day and where their activities were completely structured. Will you be able to work that structure into your home life? Waking your child up and putting them to bed at the same time every day, even weekends? Will you be able to eat at the same time every day? What type of activities will you schedule for your child when they get home from school? As your transition time lengthens, you will may be eventually be able to get back to more of a normal life, but when your child first comes home, that structure is very important.  Make sure you have a plan to continue consistent individual therapy sessions for your child. As a family it may also be very important that you all go back to or continue counseling.