ABSTRACT
Residential programs are designed to provide 24-hour care for youth who are unable to be maintained in the community due to the severity of emotional and behavioral difficulties, or as a result of incarceration for criminal behaviors. Typically, these children are at risk for being a danger to themselves or others, and require a safe, fully-staffed setting to ensure the stabilization of dysfunction. Placement of children and adolescents in residential treatment occurs for a variety of reasons, ranging from severe psychopathology or extreme behavior problems (including legal involvement) to significant family dysfunction that interferes with healthy and successful academic, social, and community functioning. Many young people referred for residential treatment have a long history of family dysfunction that may include experiences of abuse, domestic violence, substance abuse in the home, or neglect, and often school failure and aggressive and self-destructive behaviors. Typical diagnoses include Major Depression, Borderline Personality Disorder, Psychotic Disorders, Conduct Disorder, Substance Abuse Disorders, Post-traumatic Stress Disorder, and other severe personality and psychological disorders. They often present with symptoms of oppositional/defiant behavior, anger outbursts, severe mood disturbance, anxiety, self-injurious behaviors, substance abuse, and poor social skills. It is widely accepted that placing children in the least restrictive placement possible is the goal; however, a child’s referral for this level of care often results from the need for more intensive treatment than can be obtained through outpatient means.
