Search Tips for Parents: The Best Residential Programs for Teens
If your adolescent child receives a diagnosis for a mental health, behavioral, or substance use disorder and their therapist or psychiatrist recommends residential treatment, it’s not always easy to know where to start your search for a high-quality residential facility that specializes in treating and supporting teens.
The first thing we advise is to research any residential treatment center your teenager’s therapist presents as their preferred option. A direct recommendation or referral from a mental health professional you and your family know and trust is often the best choice. If the recommended youth treatment center does not end up as the location you prefer, then that’s okay. A personal referral is almost always the smartest place to start your search for psychiatric or substance abuse treatment for your teenage child. This is true even if you find a better fit as you research options.
There are several reasons a personal, word-of-mouth referral from a current provider is a wise place to start.
We’ll offer three.
The first is that they know your teen and your family. They know your teenager’s psychiatric history. They’re familiar with their diagnosis because they probably determined the diagnosis. They also understand what type of residential program will best fit your specific family needs.
The second is that they’ve likely researched the treatment center themselves, understand the types of support they offer, and know whether the therapeutic approach and treatment milieu will resonate with your child.
The third is that your teenager’s current provider will likely recommend a residential facility for teens that’s in your insurance network – and while that’s not a therapeutic reason, it can often influence your final decision.
Once you have a recommendation in hand though, it’s important to do your due diligence.
This article helps you with that.
Finding Residential Treatment Facilities for Teenagers
Before we offer our tips on vetting any adolescent inpatient program your teen’s therapist recommends, we should make sure we’re on the same page. If you’re reading this article, that means we make two assumptions:
- Your teenager has already received a comprehensive psychiatric evaluation administered by a mental health professional and that professional diagnosed your teen with a mental health, behavioral, or alcohol/substance use disorder.
- The assessing professional recommended a residential treatment center (RTC), as opposed to outpatient therapy, an intensive outpatient program (IOP), or a partial hospitalization program (PHP).
This article can help your expand your knowledge regardless of what level of care – IOP, PHP, or RTC – your therapist recommends. However, the information we present here is tailored to help you make a decision about and/or research residential treatment centers.
If you’re at the beginning of your teen’s treatment journey and need an overview of the entire process of finding treatment, please download our helpful guide here.
One thing that’s important for you to know is that in 2003, a group of doctors and researchers who specialize in inpatient adolescent psychiatry and adolescent inpatient treatment for alcohol and substance use disorder published an influential paper called “The Quality of Highly Regarded Adolescent Substance Abuse Treatment Programs.” Since the publication of that paper, researchers have confirmed the validity of its findings in several follow-up studies, including this one. Also, clinicians have learned the elements they identified also apply to treatment for teenagers with psychiatric diagnoses and adolescents with co-occurring alcohol/substance use and mental health disorders.
The most recent comprehensive analysis of evidence-based treatment components for adolescents in need of psychiatric care is the 2019 publication Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis. This paper confirms and expands the elements identified almost twenty years ago and offers specifics on new therapies developed since 2003 that research shows effective for teens. What’s interesting about the new paper is how much the initial research from 2003 got right. The recent developments, for the most part, expand on previously identified treatment approaches, with the notable and intentional inclusion of the Community Reinforcement and Family Training, known as CRAFT (for adults), and A-CRA (for teens).
To learn more about the CRAFT and A-CRA Models of Treatment, please read our article CRAFT: Family-Based Approaches to the Treatment-Resistant Adolescent.
Now we’ll offer our tips on how to perform your own vetting process in your search for treatment for your teenager.
Residential Treatment for Teens: What Any Teen Treatment Center Must Have
We created a ten-item version of the original nine components identified by adolescent treatment experts back in 2003. We recommend you start here, with the elements on this list. Any teen or youth treatment facility your teen’s therapist suggests should include all ten of these elements. If it doesn’t, we advise considering an alternative.
The Ten Elements of Top Adolescent Residential Treatment Centers
1. Comprehensive Evaluation
Top adolescent residential treatment centers administer complete evaluations to build a full biopsychosocial (biological, psychological, social) profile of the adolescent’s life and circumstances.
2. Individualized Plan
A top-rated adolescent residential treatment center uses its comprehensive assessment to create an individualized, custom plan tailored to individual needs identified in the assessment.
3. Complete Treatment
Treatment addresses all the mental, behavioral, or substance use disorders the teen faces. A plan that focuses on one disorder when others are present is insufficient.
4. Family Participation
Treatment includes the family, including any primary caregivers, and others active in the daily life of the teen. Evidence shows robust family engagement in treatment facilitates treatment progress.
5. Adolescent-Focused Programs
Treatment addresses specific adolescent needs. Treatment centers adapt modalities to teens and create new approaches that offer the best chance of healing and recovery.
6. Commitment and Time-in-Treatment
Adolescent residential treatment centers build trust and seek commitment from teens in treatment. More time in treatment increases the likelihood of success. Centers adapt their therapeutic milieu and techniques to resonate with teenagers. Committed and engaged teens stay in treatment longer, which improves the likelihood of treatment success and sustained recovery.
7. Fully Trained Team of Adolescent Specialists
Treatment center staff are specialists in adolescent treatment. They’re trained in adolescent development, adolescent issues, and have clinical experience supporting teens with co-occurring disorders.
8. Culture, Gender, and Identity Sensitivity
Treatment center staff understand and serve the needs of their entire population. Clinicians understand and have training in treatment practices specific to females, males, LGBTQI individuals, and cultural/ethnic minorities.
9. Continuing Care
Treatment centers include practical aftercare plans and long-term recovery strategies. Effective aftercare plans include family engagement, ongoing outpatient therapy, peer support, and access to community 12-step-type programs.
10. Evaluation and Improvement
Treatment centers engage in a continuous process of self-evaluation. Programs commit to an ongoing review process in order to stay up-to-date with best practices that increase the likelihood of treatment progress and sustained recovery.
We can simplify these elements for you. Not by much, though, because all of them are important, and where psychiatric or addiction treatment is concerned, there are no shortcuts.
Here’s our simple version, all in one sentence: any treatment center must fully evaluate your child, create a custom program for your child, include elements that are teen-specific, include family engagement in treatment, meet your teen where they are – meaning their culture, identity, and gender – and offer treatment sensitive to where they are, and finally, build what’s known as an aftercare plan, which gives your teen a concrete strategy for continued healing after their time in residential treatment.
It’s important for you to know that any treatment center you seek needs to contain all those elements, and all those elements are things you need to understand individually. And hopefully, after reading this article, you’ll be able to elucidate those fundamental needs to any treatment center staff you talk to on the phone or via email regarding treatment for your teen.
This brings us to our next topic:
Once you get someone from an appropriate treatment center on the phone – or better yet, when you visit the location in person – what do you ask?
We have a list for you.
Finding the Best Residential Treatment for Your Teen: Your List of Questions
We adapted this next list from our own finding treatment guide, which we link to above. Check that guide for expanded explanations of the seven key question areas we list below. When you make contact with a candidate residential treatment center for your teen, it’s a good idea to be prepared, starting with the list below.
Have your it ready when you begin your conversations.
You can keep it next to you while you’re on the phone. You can print it out and keep it in-hand when you visit the candidate center in person. Or you can simply copy and paste these questions into an email or word/text document and send it to your contact at the center you’re considering.
Remember: you’re interviewing them to determine their compatibility with your teen, your family, and your treatment needs, as determined through a collaborative process between you, your teen, and your teen’s therapist.
Top Seven Things You Need to Ask Any Center You Consider
When you call or visit a treatment center, ask about their:
1. Licensing and Accreditation
- Maintaining licensure and accreditation ensures the treatment center follows state and local regulations that set the standard for client safety.
- The treatment center itself must be fully licensed and accredited. All treatment center staff must have the appropriate level of education and training. Staff must also hold appropriate and current licensure and accreditation.
2. Staff-to-Patient Ratio
- A good staff-to-patient ratio means a high one. The more professional clinicians and staff on hand to support your child, the better their treatment will be.
3. Emergency Policies
- Crises don’t always occur during normal 9-to-5 business hours, which is why licensed staff should be on call 24/7/365. A treatment center that does not have licensed staff on call is not a high-quality treatment center.
4. Monitoring Methods
- Line-of-sight and line-of-hearing policies are vital. These policies ensure all teens are within sight and hearing of staff at all times. At all times.
- Locked or Unlocked? Licensing and regulations for locked vs. unlocked facilities differ state to state. If a facility is unlocked, protocols should be in place in the event a teen decides to leave the facility before official discharge.
5. Access to Potentially Dangerous Objects
- During treatment, a teen should not have access to any objects they might use to harm themselves. Therefore, sharp objects such as knives, scissors, and razors should be kept under lock and key. They should be closely monitored when taken out for use, and protocols should exist for accounting for all objects when they’re returned to their appropriate place.
6. Behavior Modification Strategies
- Parents should be aware of, and comfortable with, the types of behavior modification strategies that will be utilized as a part of their child’s treatment plan.
7. Contact with Others
- While in residential treatment, teens should focus on healing. Outside interaction (visits, letters, and phone calls) should be limited to a select group of appropriate individuals approved in advance by parents and the treatment team.
If you’re unsure how to ask these questions, we can offer the beginnings of a script. For instance, take item #1 on the list. Here’s an example of what you can say:
“I have some questions about your licensing and accreditation. Is your facility licensed by [the State of California, for instance]? Are your therapists qualified? What level of education do you require your therapists to have? Have they received specialized training in supporting and treating adolescents with [depression, anxiety, substance use disorder]?
Use a similar outline for the rest of the elements on the list. The admissions staff at top-quality residential treatment centers for teens should be able to answer all the questions above readily and thoroughly. One hallmark of the best inpatient psychiatric or addiction centers for teens is the level of training their admissions staff receive. Admissions staff should not only be friendly and compassionate, they should also be knowledgeable about the treatment center they work for.
In fact, a knowledgeable admissions staff is a good sign: call it your first green light for that center. And conversely, an admissions staff that does not seem knowledgeable, or appears vague and unclear about the core components of your teenager’s treatment – the level of staff training and licensure, for instance – is a red flag.
Your Teen, Your Choice: Use Your Instinct and Don’t Settle
We want to reiterate something we mentioned above: you’re the one interviewing and vetting the treatment center. Therefore, the final decision is yours. The treatment center you choose, whether your teenager is diagnosed with depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), emotional regulation issues, a behavioral disorder, or something else, needs to meet your standards and expectations.
You have the right to choose the best treatment for your teenager.
There are clinical and professional elements that are easy to verify. Confirming types of treatment offered, support services offered, licensure, accreditation, and the like should be simple. Those are matters of fact and record. However, there are other things to consider. For instance, you should be comfortable with the feeling you get from the staff you contact and the environment the treatment facility itself creates.
We advise you to follow your instinct on some of these things. If you feel the treatment center staff are knowledgeable, compassionate, empathetic, friendly, and willing to communicate, then that’s a big plus in their favor, in our opinion. And if they have all the verifiable professional and clinical elements in place, even better. That’s a treatment center that may belong toward the top of your list.
If you get the impression that the staff are not those things – kind, caring, and compassionate – then we advise you to consider an alternative. And if the admissions staff or contact person at a treatment center you’re considering is unable to give you clear, concise, logical, and helpful answers to all of the questions above, then rethink that option. That does not bode well, in general. We advise you to cross that treatment center off the list and move on to the next one.
Remember: when you seek treatment and support for your teen, you do not have to settle. You can find a treatment center that meets all the criteria above. You can find the best available treatment. When you do your due diligence, starting with reading an article like this one, your family can rest assured your teen is in a place where they can heal, grow, and take the first steps toward lifelong recovery.