Residential treatment center
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A residential treatment center (RTC) sometimes called rehab, is a live-in facility providing therapy for substance abuse, mental illness, or other behavioral problems. Residential treatment should, in many cases, be considered the "last-ditch" approach to helping a child with severe problems.[1]
Contents
Children and teens
RTCs for adolescents provide behavior modification for patients who present a variety of conditions, ranging from drug abuse to violence to sexual behavioral problems. Different RTCs work with different grades of problems, and so the structure and methods of RTCs varies. Some RTCs are lock-down facilities; that is, the residents are locked inside the premises; however, other RTCs don't lock the residents in.
There are generally two types of residential treatment centers: locked and unlocked. In a locked residential treatment facility, patients movements are severely restricted, usually to a single room or cell. By comparison, an unlocked residential treatment facility allows patients to move about the facility with relative freedom, but they are only allowed to leave the facility under specific conditions. Residential treatment centers should not be confused with residential education programs, which offer an alternative environment for at-risk children to live and learn together outside their homes.
Residential treatment centers for children and adolescents treat multiple conditions from drug and alcohol addictions, to emotional and physical disorders as well as mental illnesses. Various studies on youth in residential treatment centers have found that many children in these facilities have had a history of family-related issues, often including physical or sexual abuse. Along with these issues, many children display aggressive behaviors. Most residential treatment centers cater to troubled teens with ADHD and ADD, family problems, behavioral disorders, educational issues, and behavioral issues that puts them at risk.[2]
Residential treatment centers generally are clinically focused and primarily provide behavior management and treatment for adolescents with serious issues.[3] In contrast, therapeutic boarding schools provide therapy and academics in a residential boarding school setting, employing staffs of social workers, psychologists, and psychiatrists to work with the students on a daily basis. This form of treatment has a goal of academic achievement as well as physical and mental stability in children and young adults.[4] Recent call have occurred to ensure that residential treatment facilities have more input from behavioral psychologists to improve outcmes and lessen unethical practice [5]
Behavioral Interventions
Behavioral interventions has been very helpful in reducing problem behaviors in residential treatment centers [6]. The type of residential (conduct disorder youth versus mental retardation versus psychiatric populations) does not appear to be a factor in the effectiveness of behavioral programming [7] Behavioral intervention has been found to be successful even when medication interventions fail (i.e.,[8] )
Controversy
Disability rights organizations, such as the Bazelon Center for Mental Health Law, oppose placement in such programs and call into question the appropriateness and efficacy of such group placements, the failure of such programs to address problems in the child’s home and community environment, the limited or no mental health services offered and substandard educational programs. Concerns specifically related to a specific type of residential treatment center called therapeutic boarding schools include:
- inappropriate discipline techniques,
- medical neglect,
- restricted communication such as lack access to child protection and advocacy hotlines, and
- lack of monitoring and regulation.
Bazelon promotes community-based services on the basis that they are more effective and less costly than residential placement.[9]
From late 2007 through 2008, a broad coalition of grass roots efforts, prominent medical and psychological organizations that including members of Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (ASTART) and the Community Alliance for the Ethical Treatment of Youth (CAFETY), provided testimony and support that led to the creation of the Stop Child Abuse in Residential Programs for Teens Act of 2008 by the United States Congress Committee on Education and Labor[10].
Jon Martin-Crawford and Kathryn Whitehead of CAFETY testified at a hearing of the United States Congress Committee on Education and Labor on April 24, 2008,[11] where they described abusive practices they had experienced at the Family Foundation School and Mission Mountain School, both therapeutic boarding schools.[12][13]
Due to the absence of regulation of these programs by the federal government and because many are not subject to state licensing or monitoring [14], the Federal Trade Commission has issued a guide for parents considering such placement [15]
Research on effectiveness
Studies of different treatment approaches have found that residential treatment is effective for individuals with a long history of addictive behavior or criminal activity.[16][17][18][19] RTCs offer a variety of structured programs used to accommodate their residents' needs.
See also
- Related topics
- Specific Programs
References
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- RESIDENTIAL TREATMENT PROGRAMS Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth
- RESIDENTIAL FACILITIES State and Federal Oversight Gaps May Increase Risk to Youth Well-Being
- RESIDENTIAL PROGRAMS Selected Cases of Death, Abuse, and Deceptive Marketing
- Bazelon Center for Mental Health Law and Policy: Fact Sheet: Children in Residential Treatment Centers
- Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment
- Judge David L. Bazelon Center for Mental Health Law
- Community Alliance for the Ethical Treatment of Youth
- Coalition for Residential Education
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- Behavior modification
- Psychotherapy
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