One of the hardest decisions a parent can make is to admit a child to the hospital. When that child is a teen with mental health issues, the choice of admitting the teen to a residential treatment center is even harder. To the parents, it may feel like they are giving up on the child. The child may feel like he or she is being abandoned. It’s tough for everyone involved.
But the truth of the matter is that residential treatment centers are sometimes the best option for teens with mental health issues. These centers can aid adolescents whose health is in jeopardy within their community. This includes teens who have not responded to outpatient treatment, who cannot focus in a regular school setting, or those who need intensive therapy and a strict medication regimen supervised by a psychiatrist.
Parents may also be surprised to learn that there are residential treatment centers for not only emergencies, but for inpatient treatment of all forms of mental health issues. There are centers devoted to helping teens with depression, bipolar disorder, anxiety, and panic disorder, eating disorders, and so much more.
Prior to choosing a residential treatment center, it is important that you consult with your teen’s physician, psychologist, and other members of the treatment team to help you determine which site would be best for your child. There are multiple factors to consider and many things parents and teens should know about residential treatment centers.
Staff and Physicians – Credentials
When you are determining which facility to choose, you must do a thorough review of the education and experience of the doctors and treatment staff. The administrators need to be experienced in medical facility administration and have experience as a doctor, nurse, or other medical professional. It is crucial that administrators understand what day to day medicine looks like and especially how difficult it is to work with mentally fragile patients in a residential treatment center.
The physicians available in the facility should specialize in mental health disorders. Psychiatrists not only hold a medical degree, but they have three to four years of additional training and clinical hours in psychiatric care. They focus on the biological side of mental health – how the brain works and what dysfunctions cause mental health issues.
The facility should also have family practitioners available for basic health concerns of patients. It is critical to successful treatment that the patients in the facility are physically healthy. The doctors would be able to help with things like strep throat, the stomach flu, mono, or other communicable but not life-threatening conditions.
Nurses earn their licensure through the state they practice in. They can also work toward special certification in mental health and psychiatric care. You want to ensure that most if not all the nurses at the facility have either completed this extra certification or are working toward it.
When you are narrowing down your choices, you should schedule interviews with the facility administrator, attending physician, and nurse manager. Come prepared to ask questions about the education and experience of all staff members as well as the success rates of individual and diagnostic treatment plans (generalized treatment plans based on a diagnosis rather than the individual patient).
You are also perfectly within your rights to ask for background checks on all employees. If you intend to leave your child in the care of strangers, there is nothing wrong with you making sure the facility and its staff are safe.
When you tour the facility, ask to be taken into more than one room to ensure that there isn’t a “show” room used only for tours. Visit patient rooms and ask questions. Have your teen ask questions if he or she is with you. During the tour, observe the interaction between staff and residents. Is there open hostility? Is there a positive vibe? Do the staff and residents get along? What forms of discipline are used?
The interactions between staff, doctors, administrators, and residents will tell you so much about the environment of the residential treatment facility.
Individual, Family, and Group Therapy
Each patient will have individual therapy sessions during his or her stay. This is a critical part of the treatment plan. If you’ve had your teen in therapy prior to a stay in a residential treatment center, then individual therapy shouldn’t be a big deal. But, if your teen has never participated in family therapy or group therapy, there could be some issues,
For example, the teen may not want to talk in front of specific members of the family or in front of a group, fights could break out during therapy, or siblings of the teen may resent having to go to therapy.
During your interviews with staff and tour of the facility, ask about family and group therapy planning. Make sure that your teen has access to family therapy.
Your teen may feel isolated and cut off from the family while staying in a residential treatment facility. Having weekly or bi-weekly family therapy can be an important part of an overall treatment program.
Group therapy is also a standard part of treatment in a residential treatment facility. Some teens may not feel comfortable with the idea, but it is up to the teen’s assigned psychiatrist, psychologist, or therapist to determine when he or she is ready to join group therapy.
The number of therapy sessions may seem overwhelming to everyone in the family, not just the patient. However, that is the critical piece of inpatient treatment. While the physicians are monitoring and adjusting medications, therapists are there to monitor the patient’s change in symptoms as meds are changed, in addition to offering psychotherapy.
Academic Components
Should your teen need inpatient treatment during the school year, you want to make certain that the residential treatment center offers academic support. The facility administrator should be able to provide a comprehensive program for students who need to continue with their academics while receiving treatment. Some treatment centers will have fully loaded classrooms and students attend classes on a regular schedule. Other centers will offer tutoring and personal education plans.
It is essential that your student does not fall behind academically during treatment. It is difficult enough for your student to not be in a regular school environment during this stressful time. Should they fall behind in schoolwork due to their treatment, there is the chance that they will resent being in treatment, and it will slow down their progress.
One of the best things about academic programs in residential treatment centers is that it offers students a routine close to what they are used to at home. That kind of consistency gives them the opportunity to focus on what they must to ensure their mental health improves. For many diagnoses, the first step in treatment is to create a solid routine that does not vary. Teens with bipolar disorder or obsessive compulsive disorder experience stress when everything isn’t where it should be or happen when it should. Routine and an ability to control their immediate environment are essential to successful inpatient treatment.
This can also backfire. Students who are in dire straits mentally may not have the mental resources to devote to academic work. A bipolar teen having violent mood swings and manic episodes should not be held accountable for schoolwork until the episodes are under control. A depressed teen who as attempted suicide may be constantly reminded of the environment that caused the attempt in the first place if forced to do schoolwork before reaching a place of stability.
Psychiatrists and therapists are of course aware of these issues, and the facility must have the capability to help the student complete his or her work after reaching a point of mental and physical stability without any excess pressure. A teen’s schoolwork is important, yes. But, his or her mental and physical health is the first priority in any treatment program.
Individualized Programs vs Diagnostic Based Programs
An individualized program is a treatment plan designed to meet the specific needs of your student. A diagnostic-based program will be a generalized treatment plan based on the diagnosis of the patient. For example, the treatment center may have basic diagnostic programs for patients with bipolar disorder that differ from programs for patients with obsessive compulsive disorder.
In residential treatment centers, a dual approach is best for all concerned. It is essential that any treatment plan does not just consider your teen’s diagnosis. The teen’s symptomology, medication regimen, and the reasons for choosing inpatient treatment must all be taken into consideration.
For example, if a teen has anxiety and depression (two separate diagnoses), there could be medications or treatment options for one diagnosis that would be counterproductive to the other diagnosis. Conversely, there may be treatment options that nicely wrap around each other, providing more benefits.
In creating the treatment plan, all of the teen’s physicians, therapists, and other medical professionals must be involved. Ask for a round-table approach. Have each member of the treatment team review your child’s case. Then, arrange a meeting where everyone is present.
Together, have everyone present his or her plan for treatment. Then, working with all the professionals, the parents can provide information that would prove helpful in determine which plans have the greatest potential for success for their teen. The medical team knows the science; the parents know the child. The parents can offer the team insights that medical forms have no way of providing.
Accreditation and Licensure
In some states, residential treatment centers are not required to be accredited and licensed; these requirements will vary from state to state. You have the right to request all publicly available paperwork, including any complaints filed against the facility, pending litigation, site visit evaluations, health code violations, and corrective actions. These should all be carefully considered before choosing to move forward with a facility.
There are also different types of licensures: educational, residential treatment, and behavioral/mental health. If you want the best for your teen, find a facility that carries all of these licensures. That way, you can ensure that the facility will have everything possible it needs to successfully help your teen.
The American Academy of Child and Adolescent Psychology states that a successful treatment facility will include the following:
- A comprehensive evaluation to assess emotional, behavioral, medical, educational, and social needs
- An Individualized Treatment Plan that puts into place interventions that help the child or adolescent attain certain goals
- Individual and group therapy
- Psychiatric care coordinated by a child and adolescent psychiatrist or psychiatric prescriber
- Involvement of the child’s family or support system. Model residential programs encourage and provide opportunities for family therapy and contact through on-site visits, home passes, telephone calls and other modes of communication.
- Nonviolent and predictable ways to help youth with emotional and behavioral issues. The use of physical punishment, manipulation or intimidation should not occur in any residential treatment program.
Check with your state and local Departments of Health and Human Services for their evaluation of a facility once you have narrowed down your list of potential choices. Also, ask your child’s therapist or others in your community for recommendations. Sometimes those who have worked with a facility are the best to make recommendations.
Conclusion
Putting your teen into a residential treatment facility is not easy. It can happen because of a single incident that requires hospitalization (such as suicide attempts), or because the family is no longer equipped to handle the teen’s issues in a way that’s beneficial to them.
Whatever the case may be, it is up the parents to work with the teen and therapists to determine which facility will be the right fit for their teen. They need to do plenty of research, get recommendations, and find a place close to home so that the family can participate in therapy with the teen.
Parents need to ask for help. It doesn’t mean they have failed; it means that their teen’s problems are beyond their skills and that professionals have a greater chance of helping their teen in a controlled environment.
