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The Journey to Residential Treatment: Part 2

In a previous post, I wrote about our decision to place our son in residential treatment (RTC). The decision was one of the most difficult I can imagine having to make. Making the choice to send my little boy to a place with other children who have psychiatric and behavioral needs, a place where there are adults who may or may not treat him the way he deserves to be treated, a place where he is not their child and therefore, they will not be as invested in his well-being as we, his parents, are. What would he learn? What would he be exposed to? What behaviors would he pick up and bring home? I was, quite honestly, terrified.

When looking for a Residential Treatment Center, we had a lot to consider. First and foremost, we had to determine the funding. Since D had always been completely successful in the regular classroom, he did not have an IEP (individualized education plan for students with special needs). Without an IEP, the school system would not be willing to help us financially with this placement. We did not have open mental health or children’s protective services files, so both of those options were also eliminated. We certainly did not have the money to fund this type of treatment ourselves, nor were we in a position to take out a loan. We had private insurance, but due to D’s high level of needs we had to remove him from private insurance to place him on our state insurance for children. We were completely dependent on what the state health insurance for children would pay for.

With the state insurance paying, we were required to stay in state or in a facility within a limited number of miles from the state line. The facilities that we could consider had to accept the insurance and had to be approved by the insurance.

We also had to have the insurance approve D’s medical need for this level of care. In our state, there are several levels of care in the continuum. The other levels of care include therapeutic foster care and group homes at two separate levels of care. We chose to bypass those levels of care, against the wishes of the insurance company. Due to his need for more intense structure and therapy, medical management, and frankly, because he is adopted, we were adamant that he go directly to a locked RTC. We did not want him to misunderstand and think we were placing him with another family because we did not want him. We are his family and we wanted him to be secure in that.

We started with at least a dozen options, but narrowed down to only a few that could meet his needs. There are many different models of RTCs. These includes medical models that deal mainly with diagnosis and medication stabilization. There are also behavioral modification models, facilities that treat individuals with dual diagnosis (substance abuse and mental health or drug and alcohol abuse), relationship model that uses relationships between the patient and peers or staff members to modify behaviors, family models, religious based models, and others.

We immediately eliminated a facility that had a strong religious foundation. While we are Christians, we felt they used God  more as a punishment than teaching that He is a loving, compassionate God. We did not think it was fair to allow D to be subjected to yet another punishment from God. We felt he needed to know God in the way that our family does.

We were left with three facilities. One of those facilities we visited. The grounds were beautiful, the buildings were well maintained, and the program itself was remarkable. We could really see D doing well there. They helped students to learn to accept responsibility through their equestrian program, they had a psychiatrist on staff, they also had their own step down programs. Those programs provide a placement for students who no longer need the locked RTC, but still need the intense structure. Unfortunately, they denied D. They felt they were unable to meet his needs due to his sensory processing disorder (SPD) and autism spectrum disorder (ASD).

Another facility we visited looked great on their website and on paper, but was quite different when we toured. There was broken furniture on the recess patio and in the bedroom that I was shown. There were expletives written on the walls,  and overall, the facilities were dirty and not well kept. These raised red flags quickly. When I visited the classrooms, they had the students divided by states. The state that the facility was in had their students in one classroom participating in academics. The students from the state we lived in, on the other hand, were packed into a classroom with one adult and watching tv. They were very open about the fact that the students from our state were segregated for the purpose of academics because they did not know how to teach them. I walked away from the visit in tears, picked up my phone, and called our team leader to let her know we could not accept this facility.

Last but not least, we were told in the same phone call that a facility in the state north of where we lived had accepted D and we were welcome to come visit. Based on the website, we were not convinced, but we set the appointment and headed that direction. From the minute we walked in, I had a completely different feel. The staff was very well educated, the person we talked with was knowledgeable of the program and they were willing to answer any questions. From there, we went on our tour. The facilities were clean, the students were all working in the classroom. The staff member working with a student who was having a difficult time was soft spoken and working to help the student de-escalate.

This was the program for D! 

After reviewing many programs and visiting a few, I was relieved to know that D would be going to this facility. I was still terrified of the care he would truly get, the things he would learn, and the things he would be exposed to, but I was still relieved. We were moving forward with a plan.

I am including some resources that might be helpful when researching RTCs for your child.


Federal Trade Commission: Questions to Ask –

National Alliance on Mental Illness – (find your local NAMI office for resources available in your area)

National Association of Private Special Education Centers –

The Balanced Mind Foundation – (offers online support groups for a variety of interests, including RTCs)

Additional resources can be found through your local mental health center, your child’s mental health team, and if your child receives special education services, you might also find assistance from the school district. There are many other resources available through internet searches.


Editor’s note: I encourage you to get to know Lena through the site in the groups and through her blog and Twitter. She is an amazing advocate and a good friend…even to those she met on the Internet. Lena’s blog is and twitter is @luvmycrzylife


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