Have you been searching for psychiatric residential treatment for your child? Do all the programs sound wonderful? Ads include quotes from happy parents, and lovely photos and fabulous-sounding activities. But what’s behind the ads? Residential treatment programs are diverse, but there are important elements they should all have. Here’s how to avoid low quality residential treatment.
Psychiatric residential treatment is serious stuff–it’s difficult to do–especially when troubled children and teens are put together in one facility.
Should you ask other parents for their opinion of a program? In my experience with a child in psychiatric residential care, and as a former employee of one, word-of-mouth is not the best way to assess quality or success rate. There are too many variables: children’s disorders are different; acuity is different; parents’ attitudes and expectations are different; length of time in the facility is different; what happens once a child returns home is different… It’s most helpful to ask questions of intake staff and doctors or psychologists on staff. Quality psychiatric residential care facilities have important things in common.
What to ask about the staff:
- What is the training and licensure of staff? Are there therapists with MSW degrees, registered nurses, psychiatrists and psychiatric nurse practitioners, and is a medical professional available on site 24/7?
- There should be a high staff to patient ratio, and a physically comfortable environment with lots of emotional support.
- Do the staff seem mature to you? Do they support each other, are they a team? There is often heavy staff turnover at residential treatment centers because the work is emotionally draining, so staff cohesion is as important as the qualities of each individual.
- Safety is paramount. Staff must be able to safely manage the things that can go wrong with troubled kids. They should be trained in NCI (Nonviolent Crisis Intervention), “training that focuses on prevention and offers proven strategies for safely defusing anxious, hostile, or violent behavior at the earliest possible stage.”
What to ask about programs:
- Does the program specifically identify parent/family involvement as part of treatment? Does it emphasize parent partnership with staff? Ask. Whether you live close or far from the center, even out-of-state, you should be regularly included in conversations with staff about your child’s treatment. You should also be included in a therapy session with your child periodically; some facilities can connect with you over Skype. Your child’s success in psychiatric care depends on their family’s direct involvement.
- The program should coach you in specific parenting approaches that work for child’s behavioral needs. While your child is learning new things and working on their own changes, you must also.
- You should be informed why your child is getting the treatment or behavioral modifications he/she is receiving.
Body health is mind health, and vice versa.
- Mental health treatment will include medication and therapy, but must also include positive activities and an educational program. The whole body needs care: exercise, social activities, therapeutic activities (art, music, gardening), healthy food, restful sleep, etc.
Is your child emotionally safe as well as physically safe?
- You should be able to visit the unit or cottage where your child will live, see their bedroom, and see how the other children interact with staff and how staff interact with each other.
What to ask about the business itself:
- Can you take a tour ahead of time? Can your child or teen visit too if appropriate?
- Are emergency services nearby (hospital, law enforcement) that can arrive quickly?
- Does the facility have a business license in their state? Do they have grievance procedures? Is the center accredited as a treatment facility, and by whom? In the U.S., the main accreditation authority is called JCAHO (Joint Commission on Accreditation of Healthcare Organizations).
Psychiatric residential treatment works miracles, but it doesn’t work for all children. Some need to go into treatment more than once to benefit. Some fall apart a few weeks or months after discharge. These are common. What’s important is that you and your child are taught skills for managing his or her unique symptoms, communicating well, and committing to staying well together.
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