	Residential Treatment Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

RTX 1: Needs Based Access to Service

The organization makes every effort to ensure residential treatment services are available only when a thorough assessment of current need and prior services indicate an individual requires, and will benefit from, a total milieu environment, active psycho-therapeutic and psycho-educational interventions, and around the clock care for a specified period of time.

RTX 1.01

The residential treatment program defines in writing:

admission criteria, including age, developmental stage, and available support resources;
scope of services, special areas of expertise, and range of client issues addressed;
service options and levels of care;
opportunities for family involvement and support;
opportunities for participation in community activities; and
promotion of housing unit compatibility based on age, interests and group composition.

Interpretation: The organization heightens optimal use of limited residential treatment resources through linkages with the service community and referral sources to define when residential services are the best available treatment option.

Research Note: Studies designed to identify predictors of discharge outcomes have noted that residential treatment admission criteria can be vague, categorical, and/or wide ranging and noted the importance and feasibility of linking client characteristics to interventions and outcomes.

RTX 1.02

Admission decisions are made by a team of psychiatric, medical, psychological, social service, education, and other professionals, as appropriate to the individual’s needs, service history, and service provided.

Interpretation: When facilities provide activities under contract with a “no reject” provision the interdisciplinary team reviews such admissions with attention to any special needs or services the individual may require.

Research Note: Recent research on post-discharge outcomes suggests that improved needs-based decision making is worthy of study. Data collection and dissemination may be especially important when residential treatment is routinely approved on a regional, county, or district basis for individuals who did not first receive intensive support services and for members of groups for whom poor discharge outcomes have been found. Organizations with the capacity to provide referral sources with outcomes data may be able to contribute to improved placement decision making

Research Note: Results of a residential treatment center study following three entry cohorts from admission through discharge using event history analysis to examine length of stay found that mental health issues, including crisis while in treatment, extended average length of stay and that youth with a substance abuse history are more likely to leave care by running away than children without substance abuse histories. Results suggest careful screening for substance abuse problems so children can be identified for intensive substance use prevention and intervention, and improved data collection over the course of stay for mental health concerns including standardized measures and detailed mental health assessments.

RTX 1.03

The resident and his or her family, and/or guardian are engaged in an informative placement process and are:

helped to understand the admission decision;
prepared for admission, and given the opportunity for a pre-admission visit, whenever possible; and
apprised of any available options.

Research Note: A recent state-wide study of residential treatment child and youth outcomes suggested a reexamination of how admission decisions are made, since placement of children and youth in residential treatment centers routinely occurs without youth and foster parent participation. These results are bolstered by qualitative study findings that youth rarely have involvement in placement decisions.

RTX 1.04

The program describes:

personal items a resident may bring with them, consistent with a safe, therapeutic setting;
items that are discouraged or prohibited; and
any safety procedures the program follows or consequences that can result when prohibited items are brought to campus.

Interpretation: Personal items a resident might bring with them include, for example, photos, books, a favorite toy, clothing, or hobby materials.

QUICK JUMP TO


	PURPOSE: Residential Treatment Services are delivered according to an articulated philosophy that ties individual needs to specific interventions and education, and to achievement of stated goals, such as gains in measurable skills, increased productivity and pro-social behavior, improved functioning, and a stable living arrangement in the community.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	CRITERIA Systematically developed, objective, and quantifiable statements used to assess the appropriateness of specific decisions, services, and outcomes.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	CONTRACT A formal written agreement between two or more parties that specifies the services, space, or products to be provided in exchange for some form of compensation. Also known as "purchase of service arrangement."


	INTERDISCIPLINARY TEAM A group of persons from different professions, disciplines, service areas, organizations, and/or personnel levels who collaborate to make decisions about and provide a range of services for the same consumer or consumer group. The service delivered would not be possible or as efficient if one organization or one professional alone provided the services.


	SPECIAL NEEDS A designation used in reference to conditions or characteristics of a person that reflect a need for special care, services, or treatment. When the term is used in the context of adoption services, special needs refers to conditions that make a child harder to place for adoption. This includes children who are members of sibling groups, older children, children with disabilities, children of certain racial /ethnic backgrounds, etc. When the term is used in the context of foster care it refers to the need for a higher degree of specialized case services and attention due to mental and physical disabilities. When the term is used in the context of out-of-school time services, a child or youth may have special physical, behavioral, medical, emotional, or cognitive needs that should be addressed or accommodated. The term is also used in other contexts. See also DEVELOPMENTAL DISABILITIES.


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	CLIENT See service recipient.


	DISCHARGE See CASE CLOSING


	SUBSTANCE ABUSE The misuse of a chemical substance in a manner that is detrimental to an individual's physical or mental health.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.