NUMBER 1034 • 29 AUGUST • Quality residential treatment
Residential treatment, despite criticisms of its effectiveness and despite its relatively high cost, will continue to serve the most seriously disturbed children. There will continue to be a need to place acutely disturbed children into short-term residential units until the child can be served in less restrictive but highly structured programs. Also, chronically disturbed children whose family support systems have deteriorated, or are no longer available, will need to be served in residential treatment facilities. In 1985, there were 20,000 children in residential treatment centers (Taube & Barrett, 1985). There are at least that many children placed and many thousands more needing such placements today.
There are enormous pressures on residential treatment today. The pressures are both philosophical and financial. Residential care exists in opposition to the prevailing philosophical position of treatment in
non-restrictive settings. Those who provide residential treatment face challenges to serve children of great need in the least invasive and obtrusive means. Financial pressures are shortening lengths of stay and challenging providers to come up with treatment options using less expensive staff, intensive residential programs, and professionally intensive psychotherapy contacts.
Consequently, inpatient and residential treatment programs are undergoing intense scrutiny. There is great impetus to produce programs that meet the needs of children in the briefest, most effective ways. Modern programs are having to change their model of care. They can no longer exist as stand-alone facilities, isolated from the continuum of care. They must be part of a system of care. In such a system, children’s needs are met in the most cost efficient, yet effective option.
DANIEL DALY, DIANE SCHMIDT, DOUGLAS SPELLMAN, THOMAS CRISTE, KATHERINE DINGES, JOHN TEARE
Daly, D.L., & Schmidt, M.D., & Spellman, D.F., & Criste, T.R., & Dinges, K., & Teare J.F. (1998) The boys town residential treatment centre: Treatment implementation and preliminary outcomes, Child & Youth Care Forum, Vol. 27(4), pp. 270-271