Residential treatment center
Encyclopedia
A residential treatment center (RTC), sometimes called a rehab
, is a live-in health care 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.
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 illness
es. 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.
Residential treatment centers generally are clinically focused and primarily provide behavior management
and treatment for adolescents with serious issues. In contrast, therapeutic boarding school
s 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. Recent calls have occurred to ensure that residential treatment facilities have more input from behavioral psychologists to improve outcomes and lessen unethical practice
, 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:
Bazelon promotes community-based services on the basis that they are more effective and less costly than residential placement.
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.
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, where they described abusive practices they had experienced at the Family Foundation School
and Mission Mountain School
, both therapeutic boarding schools.
Due to the absence of regulation of these programs by the federal government and because many are not subject to state licensing or monitoring, the Federal Trade Commission has issued a guide for parents considering such placement.
Specific Programs
Drug rehabilitation
Drug rehabilitation is a term for the processes of medical or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines...
, is a live-in health care facility
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
providing therapy for substance abuse
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...
, mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
, or other behavioral problems. Residential treatment should, in many cases, be considered the "last-ditch" approach to helping a child with severe problems.
Children and teens
RTCs for adolescents provide behavior modificationBehavior modification
Behavior modification is the use of empirically demonstrated behavior change techniques to increase or decrease the frequency of behaviors, such as altering an individual's behaviors and reactions to stimuli through positive and negative reinforcement of adaptive behavior and/or the reduction of...
for patients who present a variety of conditions, ranging from drug abuse
Drug abuse
Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...
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
Residential education
Residential Education, broadly defined, is a pre-college education provided in an environment where students both live and learn outside of their family homes. Varied forms of residential education have been in existence in the United States since before the nation's founding...
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
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
, to emotional and physical disorders as well as mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
es. 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.
Residential treatment centers generally are clinically focused and primarily provide behavior management
Behavior management
Behavior management is similar to behavior modification. It is a less intensive version of behavior therapy. In behavior modification the focus is on changing behavior, while in behavior management the focus is on maintaining order. Behavior management skills are of particular importance to...
and treatment for adolescents with serious issues. In contrast, therapeutic boarding school
Therapeutic boarding school
A therapeutic boarding school , alternatively known as an emotional growth boarding school, is a boarding school based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with emotional and behavioral problems,...
s provide therapy and academics in a residential boarding school
Boarding school
A boarding school is a school where some or all pupils study and live during the school year with their fellow students and possibly teachers and/or administrators. The word 'boarding' is used in the sense of "bed and board," i.e., lodging and meals...
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. Recent calls have occurred to ensure that residential treatment facilities have more input from behavioral psychologists to improve outcomes and lessen unethical practice
Behavioral Interventions
Behavioral interventions has been very helpful in reducing problem behaviors in residential treatment centers. 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. Behavioral intervention has been found to be successful even when medication interventions fail (i.e.).Controversy
Disability rights organizations, such as the Bazelon Center for Mental Health LawBazelon Center for Mental Health Law
The Bazelon Center for Mental Health Law is a national legal-advocacy organization representing people with mental disabilities in the USA. Originally known as The Mental Health Law Project, the Center was founded as a national public-interest organization in 1972 by a group of specialized...
, 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.
From late 2007 through 2008, a broad coalition of grass roots
Grass Roots
Grass Roots is an Australian television series produced by the Australian Broadcasting Corporation between 2000 and 2003.The series is set around the fictional Arcadia Waters Council near Sydney, and was primarily a satirical look at the machinations of local government...
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
Community Alliance for the Ethical Treatment of Youth
The Community Alliance For the Ethical Treatment of Youth, or CAFETY, is an advocacy group for people enrolled in residential treatment programs for at-risk teenagers. The group's mission includes advocating for access to advocates, due process, alternatives to aversive behavioral interventions,...
(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
United States Congress
The United States Congress is the bicameral legislature of the federal government of the United States, consisting of the Senate and the House of Representatives. The Congress meets in the United States Capitol in Washington, D.C....
Committee on Education and Labor.
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, where they described abusive practices they had experienced at the Family Foundation School
Family Foundation School
The Family Foundation School is a private, co-educational, college preparatory, therapeutic boarding school located in Hancock, New York. It was founded in 1984.-History:...
and Mission Mountain School
Mission Mountain School
Mission Mountain School was a therapeutic boarding school for girls located in Condon, Missoula County, Montana. It operated from October 1, 1990 to August 16, 2008...
, both therapeutic boarding schools.
Due to the absence of regulation of these programs by the federal government and because many are not subject to state licensing or monitoring, the Federal Trade Commission has issued a guide for parents considering such placement.
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. RTCs offer a variety of structured programs used to accommodate their residents' needs.See also
Related topics- Anti-psychiatryAnti-psychiatryAnti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...
- Behavior modification facilityBehavior modification facilityA behavior modification facility is a residential educational and treatment institution enrolling adolescents who are perceived as displaying antisocial behavior, in an attempt to alter their conduct. As of 2008 there were about 650 nongovernmental, residential programs in the United States...
- Therapeutic boarding schoolTherapeutic boarding schoolA therapeutic boarding school , alternatively known as an emotional growth boarding school, is a boarding school based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with emotional and behavioral problems,...
Specific Programs
- Bridges To RecoveryBridges To RecoveryBridges To Recovery is a residential treatment center for patients suffering from psychiatric disorders located on the outskirts of Los Angeles, California...
- C. K. Post Addiction Treatment Center
- Provo Canyon SchoolProvo Canyon SchoolProvo Canyon School is a residential treatment center for teenagers with two campuses in Utah. The boys' campus is in Provo and the girls' campus is in Orem. The primary focus of the school is residential treatment for emotionally troubled youth...
- West Ridge AcademyWest Ridge AcademyWest Ridge Academy , is a youth residential treatment center based in West Jordan, Utah, USA. It seeks to provide clinical services, education, and other programs for teens, both girls and boys, that are identified as at risk. Until 2005, the Utah Boys Ranch was male-only...
- Sorenson's Ranch SchoolSorenson's Ranch SchoolSorenson's Ranch School is a fully functioning ranch that helps struggling youth. Sorenson’s Ranch School is located in Koosharem, Utah. Sorenson’s Ranch School is a licensed residential treatment center in the State of Utah that assists troubled teens. It seeks to provide clinical services,...