Residential care for children with behavior problems is often used as a last resort, once families have tried outpatient therapy, in-home counseling and other less restrictive services without success, notes the Maryland Coalition of Families for Children's Mental Health. The length of stay will depend on the child’s level of behavior problems, motivation to engage in treatment and the program’s overall goals.
Common Behavior Problems
Children who attempt suicide, self-mutilate or threaten to carry out such acts of self-violence might be good candidates for residential care. In such settings, the staff is able to monitor them continuously and ensure that they remain safe. Children who pose a risk to others may also benefit from residential care. For example, children who engage in acts of physical violence such as fighting, sexual assault or making serious threats of violence may need to be treated in a residential setting. Further, children with fire-setting behaviors, who are cruel to animals or who carry out serious acts of property destruction may need residential treatment.
Admission to Residential Treatment
The admission criteria for each residential treatment program is different, but generally, all residential facilities will require children to complete an intake assessment, psychiatric evaluation and/or psychological evaluation. The facility will also typically interview the family to gain a broader perspective on the scope of the child’s behaviors. If the child is already seeing an outpatient therapist or is receiving other mental health services, such as day treatment, his existing clinicians may need to make the referral for residential services before he will be considered for admission.
Treatment in the Residential Setting
In the residential setting, children will receive several types of treatment. This will typically include individual counseling, group therapy, behavioral interventions and psychoeducation, which teaches how to manage anger, emotions, impulses and other behaviors with which the child might be struggling. Some residential facilities also offer vocational and rehabilitation counseling to older kids. Further, some programs require parents to participate in some aspects of treatment, such as family therapy or classes on how to manage severe behavioral issues at home.
Choosing a Residential Treatment Program
The American Academy of Child and Adolescent Psychiatry advises parents to research residential treatment programs carefully before choosing a facility. Specifically, look for programs that meet the child’s broad range of needs, including his social and educational development. Additionally, the AACAP recommends that parents avoid facilities that use physical punishments or coercion instead of non-forceful therapies in addressing behavioral issues.