Factor I: Severity of Issues

For this factor, we look at the total impact the issues are having on the family.  Some children may be best served in outpatient therapy, a partial hospitalization program, or an intensive outpatient program.  Others may need a mid-level option such as a therapeutic boarding school, or a high level option like a psychiatric hospital.

If you are having the same arguments over and over, or if your child no longer responds to your redirection or advice, a therapeutic reset may be needed.  Removing your child from the home and placing them in a therapeutic environment is the fastest, most sure way of getting them back on the right track.

Getting proper treatment also involves keeping your child safe.  Suicidal thoughts, attempts, and self-harm need to be considered.  Violence inside and outside the home is often looked at differently by facilities and should be carefully evaluated.  If your child has ever run away, we will need to consider this when looking at programs.  There are different levels of elopement, and programs vary on who they will accept.  A habitual runner may need to attend a locked facility and would likely need a transport service- which can be arranged with the help of an educational consultant.

You can find a blog post on the level of programs available here.

At the highest level we have inpatient psychiatric facilities which essentially perform crisis stabilization, assessment, and/or detox.  The next level is a locked RTC, wilderness or working ranch programs, followed by a therapeutic boarding school.  Finally we have emotional growth boarding schools, and traditional boarding schools.  Down the line are partial hospitalization programs, intensive outpatient programs, and finally individual and group outpatient therapy.  There is some overlap depending on the individual program in question.

For a child that is in immediate danger to themselves or others, a program at the highest levels are needed.  For example, if a child has made a serious suicide attempt, a locked unit is going to be necessary.  For a child is in moderate danger, such as making verbal threats, but no violence outside the home- a wilderness based program might be appropriate.  At the lower end, a child that is committed to treatment and wants assistance might be best helped in a therapeutic boarding school or lower level of care.

Parents often struggle finding the right program for students with attachment issues, intellectual challenges, and sexual acting out.  Transgender issues can also present placement challenges.  This illustrates one reason why hiring a knowledgeable educational consultant is so important.

For a more detailed explanation of this factor- and looking at whether a therapeutic boarding school in particular is the right level, please see the blog post titled, “How to Choose the Best Therapeutic Boarding School for your Child.”

References for this page:

Den Dunnen W., St , Pierre J., Stewart S.L., Johnson A., Cook S., Leschied A.W. (2012). “Predicting residential treatment outcomes for emotionally and behaviorally disordered youth: The role of pretreatment factors”. Residential Treatment for Children & Youth. 29 (1): 13–31.

Evaluating Private Residential Treatment Programs for Troubled Teens, FTC Urges Caution When Considering ‘Boot Camps’, FTC Federal Trade Commission, Retrieved August 18, 2014 from: https://www.ftc.gov/news-events/press-releases/2008/07/evaluating-private-residential-treatment-programs-troubled-teens

“Predicting elopement from residential treatment centers.”  American Journal of Orthopsychiatry. 64: 126–135.

Click on a Factor below to explore the topic:

I. Severity of Issues

II. Etiology (how the issue was formed)

III. Diagnostic Cluster

IV. How the Child Handles Frustration and Discord

V. Child’s Belief System and Prevalent Issues

VI. Cost and Length of Stay, VII. Academics

VIII. The Child’s Interests, IX. Program Location, and X. Everything Else