Treating Children And Adolescents In Residential And Inpatient Settings

Each year more than 50,000 children and adolescents receive mental health treatment in residential and inpatient settings such as hospitals, group homes, and residential treatment centers. How is a decision made to disrupt a child's or teen's environment and place him or her in a program? What factors should be considered? What kinds of treatment are offered in these settings? How cost-effective and productive are these programs? Suggesting guidelines for how and when to use these special services, Treating Children and Adolescents in Residential and Inpatient Settings provides a useful assessment of current therapeutic models and inpatient/residential treatment options. The authors review the findings of published program evaluations and discuss effective alternatives to residential placement, such as part-time day and community-based treatment. The book also includes a list of relevant resources that both professionals and parents will find helpful, including information on locating professional and advocacy organizations, publications, and assessment materials. Referring a child or teen to an intensive residential or inpatient treatment program is a major decision that affects the whole family. Treating Children and Adolescents in Residential and Inpatient Settings will help both professionals and parents make better informed decisions about institutionalizing children and adolescents. Likewise, students, researchers, and scholars in clinical/counseling psychology, developmental psychology, nursing, behavioral psychology, and social work will find interesting and pertinent information in this volume.

Residential and inpatient treatment of children and adolescents is a field that is still in the process of defining itself and of demonstrating its effectiveness. Because of the continuous nature of the field's development, it is especially important that a broad range of its theoretical orientations and therapeutic techniques be considered and critically appraised. Residential and inpatient treatment is unique in its potential for both positive and negative outcomes. No other interventions can bring about the major changes in all aspects of a child's environment that inpatient hospitalization or residential treatment can. These changes may result in rapid and significant improvements in a child's condition, or they may conceivably lead to additional maladaptive behavioral patterns or inappropriate emotional and cognitive responses. Therefore, the obligation to consider the entire range of treatment alterna tives and to empirically determine the effectiveness of specific interventions is particularly great. Residential and inpatient treatment is also an expensive and limited resource, and our wise utilization of it should be guided by a comprehensive understanding of its benefits and limitations.

"Practical and authoritative, this volume belongs on the desks of clinical psychologists, psychiatrists, social workers, and other clinicians working with children and families; agency administrators and policy makers; clinical researchers; and students training in the use of evidence-based mental health treatments. It may serve as a text in graduate-level courses and MST training seminars."--BOOK JACKET.

In the past few years, there has been a major shift in the mental health care of child and adolescents from inpatient care to non-hospital community ambulatory settings. Economic pressures have primarily driven this change in service delivery. Insurance companies and managed care organizations have not only restricted access to hospitalization and limited length of stays but additionally have sharply reduced reimbursements for treatments. State and federal policies for inpatient treatment and reimbursement have followed similar trends. As a result, mental health planners have attempted to develop programs to deal with this trend of restricted inpatient care shifting treatment of children and adolescents to home and community settings. Some of these new programs are well planned and others are hastily planned and implemented. The pitfall to this community approach is that there is a population of chronically disturbed children and adolescents, and highly stressed parents often lacking adequate personal and family resource who may not respond to these new less restrictive, less costly community approaches which potentially may lead to an unsafe and dangerous situation for the child, adolescent, family and the community. With this in mind, the purpose of this book is to provide comprehensive and up-to-date information regarding child and adolescent outpatient, day treatment and community psychiatry. The emphasis of this book is to provide practical knowledge through clinical case illustrations and to explain various strategies in a detailed fashion.

This highly practical resource integrates the powerful dynamics of family into residential treatment and outdoors-based therapy for young people. Recognizing both the family as the systemic base for promoting change in adolescents and the therapeutic potential of the residential/wilderness setting, experts show how aligning the two can enhance the healing value of the program while promoting higher standards for care. Chapters describe innovative, science-based interventions and techniques for treating common behavioral and emotional problems along a continuum of family involvement and separation, to address issues affecting the family as well as the identified patient. With its accessible ideas and compelling case studies, the book ably demonstrates the critical role of family in adolescent patients’ successful transition to post-treatment life. Among the topics covered: • A parallel process: home therapy while the adolescent or young adult is in residential care.• Intentional separation of families: increasing differentiation through wilderness therapy.• Emerging family therapy models utilized in residential settings.• Engaging families in Outdoor Behavioral Healthcare.• Research on coping skills used by youth with emotional and behavioral disorders.• Expanding our understanding of the place of family therapy in residential treatment. Family Therapy with Adolescents in Residential Treatment offers novel, exciting, and effective strategies and techniques for practitioners and mental health professionals particularly interested in family therapy with adolescents, and in related interventions and research.

Therapeutic Residential Care For Children and Youth takes a fresh look at therapeutic residential care as a powerful intervention in working with the most troubled children who need intensive support. Featuring contributions from distinguished international contributors, it critically examines current research and innovative practice and addresses the key questions: how does it work, what are its critical “active ingredients” and does it represent value for money? The book covers a broad spectrum of established and emerging approaches pioneered around with world, with contributors from the USA, Canada, Scandinavia, Spain, Australia, Israel and the UK offering a mix of practice and research exemplars. The book also looks at the research relating to critical issues for child welfare service providers: the best time to refer children to residential care, how children can be helped to make the transition into care, the characteristics of children entering and exiting care, strategies for engaging families as partners, how the substantial cost of providing intensive is best measured against outcomes, and what research and development challenges will allow therapeutic residential care to be rigorously compared with its evidence-based community-centered alternatives. Importantly, the volume also outlines how to set up and implement intensive child welfare services, considering how transferable they are, how to measure success and value for money, and the training protocols and staffing needed to ensure that a programme is effective. This comprehensive volume will enable child welfare professionals, researchers and policymakers to develop a refined understanding of the potential of therapeutic residential care, and to identify the highest and best uses of this intensive and specialized intervention.

In Residential Treatment of Adolescents, Pazaratz discusses how practitioners can remain emotionally available for the needs of their residents without feeling overwhelmed. Readers will be apprised of ways to deal judiciously with residents who try to circumvent, con, play workers off each other, and even attempt to seduce or manipulate the worker. Each chapter instructs readers to observe their clients and comprehend how they relate to the total environment, in order to determine what the resident is feeling and how he or she makes use of personal resources. This contextual understanding helps to answer questions such as: What are the youngster’s goals? What factors obstruct the change process? What are the youngster’s defenses and against what? How does the youngster use the milieu (staff and peers) and the community as resources? How can the youngster get significant others to react differently to him or her? Ultimately, Pazaratz demonstrates that effective treatment staff do not create dependent youth, make treatment oppressive, or enact a role based upon giving consequences. Instead, the reader will learn to integrate diverse intervention strategies into the resident’s normal cycle of daily life and how to interact within a team structure.