A residential treatment program encompasses any residential program which treats a behavioural issue, including milder psychopathology such as eating disorders (e.g. weight loss camp) or indiscipline (e.g. fitness boot camps as lifestyle interventions). Sometimes residential facilities provide enhanced access to treatment resources, without those seeking treatment considered residents of a treatment program, such as the sanatoriums of Eastern Europe. Controversial uses of residential programs for behavioural and cultural modification include conversion therapy and mandatory American and Canadian residential schools for indigenous populations. A common feature of residential programs is controlled social access to people outside the program, and limited access for outside parties to witness daily conditions within the program. Within psychiatry, it is understood that it can be almost impossible to change entrenched behaviour without impacting habitual relationships, at least in the short term, but the relatively closed nature of many residential programs also makes it possible to conceal abusive practice.
Upon discharge, the patient may be enrolled in an intensive outpatient program for follow-up outside the residential setting.
In the 1600s, Great Britain established the Poor Law that allowed poor children to become trained in apprenticeships by removing them from their families and forcing them to live in group homes.[1] In the 1800s, the United States copied this system, but often mentally ill children were placed in jail with adults because society did not know what to do with them.[1] There were no RTCs in place to provide the 24-hour care they needed, and they were placed in jail when they could not live in the home.[1] In the 1900s, Anna Freud and her peers were part of the Vienna Psychoanalytic Society, and they worked on how to care for children.[2] They worked to create residential treatment centers for children and adolescents with emotional and behavioral disorders.
The year 1944 marked the beginning of Bruno Bettelheim's work at the Orthogenic School in Chicago, and Fritz Redl and David Wineman's work at the Pioneer House in Detroit.[2] Bettelheim helped increase awareness of staff attitudes on children in treatment.[2] He reinforced the idea that a psychiatric hospital was a community, where staff and patients influenced each other and patients were shaped by each other's behaviors.[2] Bettelheim also believed that families should not have frequent contact with their child while he or she was in treatment.[2] This differs from community-based therapy and family therapy of recent years, in which the goal of treatment is for a child to remain in the home.[3] Also, emphasis is placed on the family's role in improving long term outcomes after treatment in a RTC.[3] The Pioneer House created a special-education program to help improve impulse control and sociability in children.[2] After WWII, Bettelheim and the joint efforts of Redl and Wineman were instrumental in establishing residential facilities as therapeutic-treatment alternative for children and adolescents who can not live at home[4]
In the 1960s, the second generation of psychoanalytical RTC was created. These programs continued the work of the Vienna Psychoanalytic Society in order to include families and communities in the child's treatment.[1] One example of this is the Walker Home and School which was established by Dr. Albert Treischman in 1961 for adolescent boys with severe emotional or behavioral disorders. He involved families in order to help them develop relationships with their children within homes, public schools and communities.[2] Family and community involvement made this program different from previous programs.
Beginning in the 1980s, cognitive behavioral therapy was more commonly used in child psychiatry,[2] as a source of intervention for troubled youth, and was applied in RTCs to produce better long-term results.[2]Attachment theory also developed in response to the rise of children admitted to RTCs who were abused or neglected. These children needed specialized care by caretakers who were knowledgeable about trauma.[4]
In the 1990s, the number of children entering RTCs increased dramatically, leading to a policy shift from institution- based services to a family-centered community system of care.[5] This also reflected the lack of appropriate treatment resources. However, residential treatment centers have continued to grow and today house over 50,000 children.[6] The number of residential treatment centers in the United States is currently estimated at 28,900 facilities.[7]
Children and teens
RTCs for adolescents, sometimes referred to as teen rehab centers, provide treatment for issues and disorders such as oppositional defiant disorder, conduct disorder, depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD), educational issues, some personality disorders, and phase-of-life issues, as well as substance use disorders. Most use a behavior modification paradigm. Others are relationally oriented. Some utilize a community or positive peer-culture model. Generalist programs are usually large (80-plus clients and as many as 250) and level-focused in their treatment approach. That is, in order to manage clients' behavior, they frequently put systems of rewards and punishments in place. Specialist programs are usually smaller (less than 100 clients and as few as 10 or 12). Specialist programs typically are not as focused on behavior modification as generalist programs are.
Different RTCs work with different types of problems, and the structure and methods of RTCs vary. Some RTCs are lock-down facilities; that is, the residents are locked inside the premises. In a locked residential treatment facility, clients' movements are restricted. By comparison, an unlocked residential treatment facility allows them 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 of youth in residential treatment centers have found that many have a history of family-related issues, often including physical or sexual abuse. Some facilities address specialized disorders, such as reactive attachment disorder (RAD).
Residential treatment centers generally are clinically focused and primarily provide behavior management and treatment for adolescents with serious issues. In contrast, therapeutic boarding schools provide therapy and academics in a residential boarding school setting, employing a staff 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, adolescents, and young adults. Recent trends have ensured that residential treatment facilities have more input from behavioral psychologists to improve outcomes and lessen unethical practices.[8]
Behavioral interventions
A therapeutic self-help group at the Rehab Center Parus in Moscow
Behavioral interventions have been very helpful in reducing problem behaviors in residential treatment centers.[9] The type of clients receiving services in a facility (children with emotional or behavioral disorders versus intellectual disability versus psychiatric disorders) is a factor in the effectiveness of behavior modification.[10] Behavioral intervention has been found to be successful even when medication interventions fail.[11] However, there is evidence that certain populations may benefit more from interventions that fall outside of the behavior-modification paradigm. For instance, positive outcomes have been reported for neurosequential interventions targeting issues of early childhood trauma and attachment. (Perry, 2006).[12] Although the majority of children who receive services in RTCs present emotional and behavioral disorders (EBDs), such as attention deficit hyperactivity disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD), behavior-modification techniques can be an effective way of decreasing the maladaptive behavior of these clients. Interventions such as response cost, token economies, social skills training groups, and the use of positive social reinforcement can be used to increase prosocial behavior in children (Ormrod, 2009).[13]
Behavioral interventions are successful in treating children with behavioral disorders in part because they incorporate two principles that make up the core of how children learn: conceptual understanding and building on their pre-existing knowledge. Research by Resnick (1989)[14] shows that even infants are able to develop basic quantitative frameworks. New information is incorporated into the framework and serves as the basis for the problem-solving skills a child develops as she or he is exposed to different types of stimuli (e.g., new situations, people, or environments). The experiences and environment that a child is exposed to can have either a positive or negative outcome, which, in turn, impacts how he or she remembers, reasons, and adapts when encountering aversive stimuli. Furthermore, when children have acquired extensive knowledge, it affects what they notice and how they organize, represent, and interpret information in their current environment (Bransford, Brown, & Cocking, 2000).[15] Many of the children housed in RTCs have been exposed to negative environmental factors that have contributed to the behavior problems that they are exhibiting.
Many interventions build on children's prior knowledge of how reward works. Reinforcing children for pro-social behaviors (i.e., using token economies, in which children earn tokens for appropriate behaviors; response cost (losing previously earned tokens following inappropriate behavior; and implementing social-skills training groups, where participants observe and participate in modeling appropriate social behaviors help them develop a deeper understanding of the positive results of pro=social behavior.
Wolfe, Dattilo, & Gast (2003)[16] found that using a token economy in concert with cooperative games increased pro-social behaviors (e.g. statements of encouragement, praise, or appreciation, shaking hands, and giving high fives) while decreasing anti-social ones (swearing, threatening peers with physical harm, name-calling, and physical aggression). The use of a response-cost system has been efficacious in reducing problem behaviors. A single-subject withdrawal design employing non-contingent reinforcement with response cost was used to reduce maladaptive verbal and physical behaviors exhibited by a post-institutional student with ADHD (Nolan & Filter, 2012).[17] Wilhite & Bullock (2012)[18] implemented a social-skills training group to increase the social competence of students with EBDs. Results showed significant differences between pre- and post-intervention disciplinary referrals, as well as several other elements of behavioral-ratings scales. Evidence also exists for the usefulness of social reinforcement as a part of behavioral interventions for children with ADHD. A study by Kohls, Herpertz-Dahlmann, & Kerstin (2009)[19] found that both social and monetary rewards increased inhibition control in both the control and experimental groups. However, results showed that children with ADHD benefitted more from social reinforcement than typical children, indicating that social reinforcement can significantly improve cognitive control in ADHD children. The techniques listed are only a few of the many types of behavioral interventions that can be used to treat children with EBDs. Additional information regarding types of behavioral interventions can be found in the 2003 book Behavioral, Social, and Emotional Assessment of Children and Adolescents by Kenneth Merrell.
Types of Family Therapy used in Residential Treatment Center
Narrative Therapy: Narrative therapy has shown an increase in popularity in the field of family therapy. Narrative therapy developed out from the postmodern viewpoint, which is expressed in its principles: (a) not one universal reality exists, but socially constructed reality; (b) reality is created by language; (c) narrative maintains reality (d) not all narratives are equivalent [20](Freedman and Combs, 1996).
Narrative family therapy views human issues from those roots as emerging and being sustained by dominant stories that control the life of an individual. Problems arise when individual stories do not match with their experience of living. According to the narrative viewpoint, by offering a new and distinct perspective[21]
In a problem-saturated narrative, therapy is a process of rewriting personal narratives. The process of rewriting the narrative of the client involves (a) expressing the problem(s) they are experiencing; (b) breaking down narratives that trigger problems through questioning; (c) recognizing special outcomes or occasions where a person has not been constrained by their situation; (d) connecting specific results to the future and providing an alternate and desired narrative; (e) inviting supports among the community to spectate the new narrative and (f) logging new document [21] Since postmodern viewpoints prioritize concepts rather than techniques, in narrative therapy, formal methods are restricted. However, some researchers have described techniques that are useful in helping an individual rewrite a specific experience, like retelling stories and writing letters.
Children admitted to a residential treatment center have behavior problems so extreme that residential treatment is their last hope. Parents seem to think the child is the problem needed to be fixed, and everything will be okay; on the other hand, the child generally sees themselves as a victim. Narrative therapy enables these perspectives to be broken down and troubling behaviors of the child to be externalized, which could encourage both the child and the family members to achieve a new perspective no one feels prosecuted or blamed.[22]
Multi Systemic Therapy:
The model has shown success in sustaining long-standing improvements in children's and adolescents' antisocial behaviors. Families in MST have demonstrated improved family stability and post-treatment adaptability and growing support, and reduced conflict- hostility[23]
The method's ultimate objectives include a) eliminating behavior problems, b) enhancing family functioning, c) strengthening the adolescents' ability to perform better at school and other community settings, and d) decreasing out-of-home placement [24]
Controversy
Disability rights organizations, such as the Bazelon Center for Mental Health Law, oppose placement in RTC programs, calling into question the appropriateness and efficacy of such placements, noting the failure of such programs to address problems in the child's home and community environment, and calling attention to the limited mental-health services offered and substandard educational programs.[citation needed] Concerns [whose?]specifically related to a specific type of residential treatment center called therapeutic boarding schools include:
Jon Martin-Crawford and Kathryn Whitehead of CAFETY testified at a hearing of the United States Congressional Committee on Education and Labor on April 24, 2008,[28] and described abusive practices they had experienced at the Family Foundation School and Mission Mountain School, both therapeutic boarding schools.[29][30]
Due to the absence of regulation of these programs by the federal government and because many are not subject to state licensing or monitoring,[31] the Federal Trade Commission has issued a guide for parents considering such placement.[32]
Residential treatment programs are often caught in the cross-fire during custody battles, as parents who are denied custody try to discredit the opposing spouse and the treatment program.[33][34]
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.[35][36][37][38] RTCs offer a variety of structured programs designed to address the specific need of the inmates. Despite the controversy surrounding the efficacy of (RTCs), recent research has revealed that community-based residential treatment programs have positive long-term effects for children and youth with behavioral problems.
Participants in a pilot program employing family-driven care and positive peer modeling displayed no incidence of elopement,[clarification needed] self-injurious behaviors, or physical aggression, and just one case of property destruction when compared to a control group (Holstead, 2010).[39] The success of treatment for children in RTCs depends heavily on their background i.e., their state, situation, circumstances and behavioral status before commencement of treatment. Children who displayed lower rates of internalizing and externalizing behavior problems at intake and had a lower level of exposure to negative environmental factors (e.g., domestic violence, parental substance use, high crime rates), showed better results than children whose symptoms were more severe (den Dunnen, 2012).[40]
Additional research demonstrates that planned treatment, or knowing the expected duration of treatment, is strongly correlated with positive treatment outcomes. Long-term results for children using planned treatment showed that they are 21% less likely to engage in criminal behavior and 40% less likely to need hospitalization for mental-health problems (Lindqvist, 2010).[41] Further evidence exists supporting the long-term effectiveness of RTCs for children exhibiting severe mental health issues. Preyde (2011)[42] found that clients showed a statistically significant reduction in symptom severity 12–18 months after leaving an RTC, results which were maintained 36–40 months after their discharge from the facility.
However, although there is a great deal of research supporting the validity of RTCs as a way of treating children and youth with behavioral disorders, little is known about the outcomes-monitoring practices of such facilities. Those that track clients after they leave the RTC only do so for an average of six months. In order to continue to provide effective long-term treatment to at-risk populations, further efforts are needed to encourage the monitoring of outcomes after discharge from residential treatment (J.D. Brown, 2011).[43]
One problem that hinders the effectiveness of RTCs is elopement or "running". A study by Kashubeck found that runaways from RTCs were "more likely to have a history of elopement, a suspected history of sexual abuse, an affective-disorder diagnosis, and parents whose rights had been terminated."[44] By employing these characteristics of patients in the design of treatment, RTCs may be more successful in reducing elopement and otherwise improving the probability of clients' success.
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally-inappropriate.
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior that includes theft, lies, physical violence that may lead to destruction, and reckless breaking of rules, in which the basic rights of others or major age-appropriate norms are violated. These behaviors are often referred to as "antisocial behaviors", and is often seen as the precursor to antisocial personality disorder; however, the latter, by definition, cannot be diagnosed until the individual is 18 years old. Conduct disorder may result from parental rejection and neglect and can be treated with family therapy, as well as behavioral modifications and pharmacotherapy. Conduct disorder is estimated to affect 51.1 million people globally as of 2013.
Anti-social behaviours, sometimes called dissocial behaviours, are actions which are considered to violate the rights of or otherwise harm others by committing crime or nuisance, such as stealing and physical attack or noncriminal behaviours such as lying and manipulation. It is considered to be disruptive to others in society. This can be carried out in various ways, which includes, but is not limited to, intentional aggression, as well as covert and overt hostility. Anti-social behaviour also develops through social interaction within the family and community. It continuously affects a child's temperament, cognitive ability and their involvement with negative peers, dramatically affecting children's cooperative problem-solving skills. Many people also label behaviour which is deemed contrary to prevailing norms for social conduct as anti-social behaviour. However, researchers have stated that it is a difficult term to define, particularly in the United Kingdom where many acts fall into its category. The term is especially used in Irish English and British English.
A 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.
Child psychopathology refers to the scientific study of mental disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and autism spectrum disorder are examples of psychopathology that are typically first diagnosed during childhood. Mental health providers who work with children and adolescents are informed by research in developmental psychology, clinical child psychology, and family systems. Lists of child and adult mental disorders can be found in the International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10), published by the World Health Organization (WHO) and in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association (APA). In addition, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood is used in assessing mental health and developmental disorders in children up to age five.
Behavior modification was a treatment approach that used respondent and operant conditioning to change behavior. Based on methodological behaviorism, overt behavior was modified with (antecedent) stimulus control and consequences, including positive and negative reinforcement contingencies to increase desirable behavior, as well as positive and negative punishment, and extinction to reduce problematic behavior.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness." This behavior is usually targeted toward peers, parents, teachers, and other authority figures, including law enforcement officials. Unlike conduct disorder (CD), those with ODD do not generally show patterns of aggression towards random people, violence against animals, destruction of property, theft, or deceit. One-half of children with ODD also fulfill the diagnostic criteria for ADHD.
Wilderness therapy, also known as outdoor behavioral healthcare, is a treatment option for behavioral disorders, substance abuse, and mental health issues in adolescents. Patients spend time living outdoors with peers. Reports of abuse, deaths, and lack of research into efficacy have led to controversy, and there is no solid proof of its effectiveness in treating such behavioral disorders, substance abuse, and mental health issues in adolescents.
Despite the scientifically well-established nature of attention deficit hyperactivity disorder (ADHD), its diagnosis, and its treatment, each of these has been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, stated that the current treatments and methods of diagnosis are based on the dominant view of the academic literature.
A mental health professional is a health care practitioner or social and human services provider who offers services for the purpose of improving an individual's mental health or to treat mental disorders. This broad category was developed as a name for community personnel who worked in the new community mental health agencies begun in the 1970s to assist individuals moving from state hospitals, to prevent admissions, and to provide support in homes, jobs, education, and community. These individuals were the forefront brigade to develop the community programs, which today may be referred to by names such as supported housing, psychiatric rehabilitation, supported or transitional employment, sheltered workshops, supported education, daily living skills, affirmative industries, dual diagnosis treatment, individual and family psychoeducation, adult day care, foster care, family services and mental health counseling.
Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a rare mental disorder in children and adolescents. The diagnosis of bipolar disorder in children has been heavily debated for many reasons including the potential harmful effects of adult bipolar medication use for children. PBD is similar to bipolar disorder (BD) in adults, and has been proposed as an explanation for periods of extreme shifts in mood called mood episodes. These shifts alternate between periods of depressed or irritable moods and periods of abnormally elevated moods called manic or hypomanic episodes. Mixed mood episodes can occur when a child or adolescent with PBD experiences depressive and manic symptoms simultaneously. Mood episodes of children and adolescents with PBD are different from general shifts in mood experienced by children and adolescents because mood episodes last for long periods of time and cause severe disruptions to an individual's life. There are three known forms of PBD: Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS). The average age of onset of PBD remains unclear, but reported age of onset ranges from 5 years of age to 19 years of age. PBD is typically more severe and has a poorer prognosis than bipolar disorder with onset in late-adolescence or adulthood.
Child psychotherapy, or mental health interventions for children refers to the psychological treatment of various mental disorders diagnosed in children and adolescents. The therapeutic techniques developed for younger age ranges specialize in prioritizing the relationship between the child and the therapist. The goal of maintaining positive therapist-client relationships is typically achieved using therapeutic conversations and can take place with the client alone, or through engagement with family members.
Childhood trauma is often described as serious adverse childhood experiences. Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse. They may also witness abuse of a sibling or parent, or have a mentally ill parent. These events can have profound psychological, physiological, and sociological impacts leading to lasting negative effects on health and well-being. These events may include antisocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Additionally, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
The wraparound process is an intensive, individualized care management process for youths with serious or complex needs. Wraparound was initially developed in the 1980s as a means for maintaining youth with the most serious emotional and behavioral problems in their home and community. During the wraparound process, a team of individuals who are relevant to the well-being of the child or youth collaboratively develop an individualized plan of care, implement this plan, and evaluate success over time. The wraparound plan typically includes formal services and interventions, together with community services and interpersonal support and assistance provided by friends, kin, and other people drawn from the family's social networks. The team convenes frequently to measure the plan's components against relevant indicators of success. Plan components and strategies are revised when outcomes are not being achieved.
Parent management training (PMT), also known as behavioral parent training (BPT) or simply parent training, is a family of treatment programs that aims to change parenting behaviors, teaching parents positive reinforcement methods for improving pre-school and school-age children's behavior problems.
Multisystemic therapy (MST) is an intense, family-focused and community-based treatment program for juveniles with serious criminal offenses who are possibly abusing substances. It is also a therapy strategy to teach their families how to foster their success in recovery.
The adolescent community reinforcement approach (A-CRA) is a behavioral treatment for alcohol and other substance use disorders that helps youth, young adults, and families improve access to interpersonal and environmental reinforcers to reduce or stop substance use.
Project Re-ED, the Project on the Re-Education of Emotionally Disturbed Children, is a program to provide effective and affordable mental health services for children. The program focuses on teaching a child effective ways of acting in and responding to the child's social groups and also working with those social groups to help them provide a more supportive environment for the child. It began as a pilot project in the 1960s at two residential facilities in Tennessee and North Carolina. It later expanded to more facilities, and the principles of treatment developed in the project have been replicated and adapted in many other programs.
References
1 2 3 4 Callan J. E. (1976). "Residential treatment for youth: a bicentennial consideration". Journal of Clinical Child Psychology. 5 (3): 35–37. doi:10.1080/15374417609532725.
1 2 3 4 5 6 7 8 9 Cohler B.J., Friedman D.H. (2004). "Psychoanalysis and the early beginnings of residential treatment for troubled youth". Child and Adolescent Psychiatric Clinics of North America. 13 (2): 237–254. doi:10.1016/S1056-4993(03)00115-9. PMID15062343.
1 2 Geurts E. M. W., Boddy J., Noom M. J., Knorth E. J. (2012). "Family-centered residential care: the new reality?". Child & Family Social Work. 17 (2): 170–179. doi:10.1111/j.1365-2206.2012.00838.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)
1 2 Zimmerman D.P. (2004). "Psychotherapy in residential treatment: historical development and critical issues". Child and Adolescent Psychiatric Clinics of North America. 13 (2): 347–361. doi:10.1016/S1056-4993(03)00122-6. PMID15062350.
↑ Susan Yelton, Children in residential treatment — Policies for the '90s, Children and Youth Services Review, Volume 15, Issue 3, 1993, Pages 173-193, ISSN 0190-7409, 10.1016/0190-7409(93)90002-Q.
↑ Latest Findings in Children's Mental Health, Nearly 66,000 Youth Live in U.S, Mental Health Programs, Vo1. 2, No. 1 (Summer 2003). In 1997, the year in which the most recent data was available, over 42,000 children were living in RTCs. Given the growth of children living in RTCs, see supra note 2, this figure is likely well over 50,000 now.
↑ Bodfish J.W., Konarski E.A. (1992). "Reducing problem behaviors in a residential unit using structural analysis and staff management procedures: A preliminary study". Behavioral Interventions. 7 (3): 225–234. doi:10.1002/bin.2360070305.
↑ Fuoco F.J., Lawrence P.S., Vernon J.B. (1988). "Post-treatment effects of token reinforcement, verbal praise, and self-monitoring in a residential psychiatric program". Behavioral Interventions. 3 (4): 267–286. doi:10.1002/bin.2360030404.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Perry, B.D. (2006) The Neurosequential Model of Therapeutics: Applying principles of neuroscience to clinical work with traumatized and maltreated children. In N. B. Webb (Ed.), Working with traumatized youth in child welfare (pp. 27-52). New York: The Guilford Press.
↑ Ormrod, J.E. (2009). Essentials of Educational Psychology (2nd ed.). Upper Saddle River, NJ: Merrill.
↑ Bransford, J.D., Brown, A.L., & Cocking, R.R. (2000). How People Learn: Brain, Mind, Experience, and School. Washington, DC: National Academy Press.
↑ Wolfe B.D., Dattilo J., Gast D.L. (2003). "Effects of a token economy system within the context of cooperative games on social behaviors of adolescents with emotional and behavioral disorders". Therapeutic Recreation Journal. 37 (2): 124–141.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Nolan J.D., Filter K.J. (2012). "A function-based classroom behavior intervention using non-contingent reinforcement plus response cost". Education and Treatment of Children. 35 (3): 419–430. doi:10.1353/etc.2012.0017. S2CID146458391.
↑ Wilhite S., Bullock L.M. (2012). "Effects of the WhyTry social skills program on students with emotional and/or behavioral problems in an alternative school". Emotional & Behavioural Difficulties. 17 (2): 175–194. doi:10.1080/13632752.2012.675135. S2CID145588066.
↑ A National Evaluation of Treatment Outcomes for Cocaine Dependence; D. Dwayne Simpson, PhD; George W. Joe, EdD; Bennett W. Fletcher, PhD; Robert L. Hubbard, PhD; M. Douglas Anglin, PhD; Arch Gen Psychiatry. 1999;56:507-514. Abstract
↑ Effectiveness of coerced addiction treatment (alternative consequences) A review of the clinical research; Norman S. Miller M.D. and Joseph A. Flaherty M.D.b.; Journal of Substance Abuse Treatment, Volume 18, Issue 1, Pages 9-16 (January 2000) Abstract
↑ Holstead J., Dalton J., Horne A., Lamond D. (2010). "Modernizing residential treatment centers for children and youth – an informed approach to improve long-term outcomes: The Damar pilot". Child Welfare. 89 (2): 115–130. PMID20857883.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Den Dunnen W., St, Pierre J., Stewart S.L., Johnson A., Cook S., Leschied A.W. (2012). "Predicting residential treatment outcomes for emotionally and behaviorally disordered youth: The role of pretreatment factors". Residential Treatment for Children & Youth. 29 (1): 13–31. doi:10.1080/0886571x.2012.642268. S2CID954787.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Preyde M., Frensch K., Cameron G., White S., Penny R., Lazure K. (2011). "Long-term outcomes of children and youth accessing residential or intensive home-based treatment: Three year follow up". Journal of Child and Family Studies. 20 (5): 660–668. doi:10.1007/s10826-010-9442-z. S2CID72582607.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Brown J.D., Barrett K., Ireys H.T., Allen K., Blau G. (2011). "Outcomes monitoring after discharge from residential treatment facilities for children and youth". Residential Treatment for Children and Youth. 28 (4): 303–310. doi:10.1080/0886571x.2011.615237. S2CID71997407.{{cite journal}}: CS1 maint: multiple names: authors list (link)
↑ Kashubeck, Susan; Pottebaum, Sheila M.; Read, Nancy O. (1994). "Predicting elopement from residential treatment centers". American Journal of Orthopsychiatry. 64 (1): 126–135. doi:10.1037/h0079498. PMID8147421. S2CID19592323.
Further reading
Kenneth R. Rosen (2021). Troubled: The Failed Promise of America's Behavioral Treatment Programs. Little A. ISBN978-1542007887.
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