	Residential Treatment Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

RTX 2: Family Connections

The resident, family, and organization work together to determine and maintain an optimal level of family connection and involvement in treatment activities.

Interpretation: When organizations adopt a philosophy that family attachments are of primary importance for human development professional staff will strive to develop a common understanding and functional definition of “family.” This perspective, consistent with the flexible description of family reunification advanced over the last decade in professional child welfare literature, promotes positive connections at an appropriate level, as circumstances warrant, rather than “reunified” or “not reunified” perspective. When a family centered perspective is applied, care is taken to ask the resident about any individuals considered to be family members, including those related by kinship or affection, or by law, custom or their acknowledgement, including current or former foster family, adoptive family or extended family members. Adults can have important supportive relationships with friends and individuals who are surrogate family members.

RTX 2.01

The organization helps every resident to:

express the nature of family connection desired;
resolve conflicts in family relationships;
identify family strengths that help members meet challenges;
cope with family separation;
maintain relationships with family members through planned visits and shared activities;
participate in family and neighborhood activities; and
prepare for return to the family, if appropriate.

Interpretation: Unless contraindicated, residents have the opportunity to visit their family at home and receive visits from family and friends. The organization will not permit withholding of family contact, restrictions on, or cancellation of visits for disciplinary reasons. For adults, and some young adults in residential treatment centers, every attempt should be made to include family members such as a spouse, siblings, children, parents, and/or significant others identified by the adult resident. In cases where the adult resident does not want family involvement the resident receives help to identify friendship opportunities based on common interests.

Regarding element e.), planned visitation is a therapeutic, educational child welfare intervention to advance the goals of the service recipient and family member or support person, and is a positive alternative to visits that primarily satisfy a documentation requirement. Therapeutically managed visits afford opportunities for guided and facilitated parent-child interaction related to placement, treatment and family relationship issues that support on-going family connections and, possibly, family reunification efforts.

Research Note: A study reporting conflicted relationships and behavioral problems following parent visits for some children in foster care focuses attention on child and family factors that can influence positive visits, including specification of purpose and nature of visits, and preparation of children and parents.

Research Note: A well-designed descriptive cohort study of permanency plan outcomes for children placed in foster home and kinship care, found visiting at recommended (frequency) levels to be strongly associated with decisions to allow children to return home. Owing to reliance on administrative records, albeit it of high quality, the study does not shed light on quality of visits or unknown similarities and differences between study participants and children placed in residential treatment, which precludes generalizing results to older youth, and youth in placement without a reunification plan. At the same time study findings are significant and advance understanding of the importance of family connections for a range of positive post discharge outcomes.

RTX 2.02

Engagement activities support the development and maintenance of a therapeutic partnership with family members that, when possible, precedes, continues throughout, and follows the resident’s stay.

RTX 2.03

The organization supports active family member or legal guardian participation:

at admission;
in assessments;
during the treatment process and discharge planning, including preparation for return to family and community; and
in family counseling and services, unless involvement is contraindicated.

Interpretation: Family members and significant others, as appropriate and with the consent of the individual, are advised of the need for and specific aims of treatment and care, ongoing progress, and their role in case conferences.

RTX 2.04

When services cannot be provided close to a person’s home, the organization facilitates maintenance of family ties, and involvement of the family in service planning and delivery, by:

assisting the family with travel arrangements; and/or
coordinating or facilitating family services to be delivered in the community.

Interpretation: The organization should attempt to accept individuals who live nearby to allow frequent family contact. The organization must support family involvement and provide alternative services through cooperating local organizations. Transportation costs should be paid to facilitate frequent visiting and home visits. Documented exceptions can be made in situations that meet special needs and when family involvement is contraindicated.

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.


	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."


	PARENTS Parents can include: birth, foster, kinship, and adoptive parents. Please see service standards for more specific information about use of this term.


	QUALITY In this context, the extent to which contemporary and generally recognized standards for professional practice are met and exceeded, and desirable service outcomes achieved.


	OLDER YOUTH In the context of Volunteer Mentoring Services, middle school and high school students.


	LEGAL GUARDIAN A person who has legal responsibility for the care and management of a person incapable of administering his/her own affairs. In the case of a minor child, the guardian is charged with the legal responsibility for the care and management of the child and of the minor child's estate.


	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.


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.


	DISCHARGE See CASE CLOSING


	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.