January 1, 2008

Perspectives on Residential and Community-Based Treatment for Youth and Families

This paper was developed in response to concerns about the reliance on residential treatment for children and adolescents with serious emotional disturbance and the under use of evidence-based alternative treatments. It's based on reviews of the literature on the efficacy of residential treatment and alternative treatments for youth with serious emotional disturbance. We also conducted three community forums to get public input on the use of residential treatment and other alternatives. The forums were conducted in Nashville, TN on April 25, 2008, in Bucks County, PA on June 16, 2008 and in Delaware County, PA on June 17, 2008. Attendees at the forums included parents of children who had been in residential treatment as well as young adults who had received residential treatment services. Additional participants included policy makers; psychologists and psychiatrists; providers of crisis, residential and therapeutic foster care services; representatives from state child welfare, education, mental health and juvenile justice agencies; juvenile courts; Governor-appointed commissions; advocacy centers; schools and various providers. Subject matter experts included individuals with expertise in treating youth with behaviors that put themselves and others at risk, such as young people who have eating disorders or have committed sex offenses. This paper concludes that while residential treatment remains an important component of a system of care, for most youth, community-based interventions represent a more appropriate and less costly alternative to residential