Trench Warfare and Last Ditch Efforts
Would it surprise you to learn that residential treatment centers for “teens” have quite a bit in common with good old fashioned “trench warfare”? In trench warfare, armies dug trenches (or ditches) to protect their soldiers from ground gunfire or air artillery attacks. And the goals of trench warfare were two-fold: advance your battle position by digging new ditches as you gained ground moving forward, or hold your battle lines by digging new ditches as you lost ground falling backward or retreating to previously dug ones.
“…we will fight and die [if need be] to the last ditch to defend England.”
King William III of England, 17th Century
Residential Treatment Centers (RTCs) are like trench warfare. More than providing the necessary help for an adolescent’s substance abuse, mental illness, or other behavioral problems in a 24-hour, 30-day, live-in health-care facility, they are considered by many in the therapeutic-treatment world to be a “last ditch” effort to turn a troubled teen’s world around…or even to save his or her life.
When every conceivable outpatient intervention has been exhausted, there’s RTC. When conditions go so far south that containment of all outside stressors becomes a must, there’s RTC. When the courts have had enough of empty promises and the judge has to order emergency help, there’s RTC. And in the case of highly likely self-harm or life-threatening circumstances, there’s RTC.
Is your adolescent there? Is it time to pull out the big guns? Is it time to consider RTC?
Residential Treatment is an opportunity to address serious behavioral, emotional and mental health needs like never before. It is provided by licensed mental health professionals, in a medically-oriented facility, for as long as it takes to achieve the goals your teen most needs to address. It is accomplished individually, in groups, and with family. Medication can be prescribed and monitored closely. It can take from 1 to 6 months to get the results desired, but typically 30-days is the therapeutic-world standard. Most offer various experiential therapeutic activities, including equine-assisted therapy, art therapy, and structured physical-activity therapy. Alternative treatments are also available to choose from, including massage therapy, yoga therapy, acupuncture, meditation, and energy work. And finally, some of the best such treatment centers offer outpatient follow-up services for possible (God forbid) relapse purposes.1
4-Main Types of RTCs1
Clinical RTCs provide life-skills training, addiction treatments, and educational training, along with extensive therapy.
Group Home or Therapeutic Community RTC
Group RTCs use a familiar atmosphere to help residents improve mental and emotional health, develop life and relationship skills, and manage mental health symptoms.
Farm or work-related RTCs help residents achieve growth and recovery through daily work, in addition to therapeutic treatment.
Apartment-based RTC communities offer much-needed therapy in an environment where residents may maintain a modicum of independence than would be possible in other available settings.
Some RTCs focus on residents who suffer from co-occurring disorders, providing a complex marriage of integrated treatment interventions.
RTCs often specialize in certain or specific mental and emotional and behavioral issues, including:
- drug dependency
- alcohol dependency
- eating disorders
- sexual addiction
- bipolar disorder
- post-traumatic stress
- personality issues
Basics of Great RTCs2
- program treatments directly match individual needs
- treat mental health issues with a combination of medication and psychotherapy
- start with a comprehensive cognitive, emotional and social needs assessment
- develop treatment plans based directly on assessment results
- continually monitor resident progress and adjust as necessary
- whatever intervention treatments are needed are readily available
- treatment continues until goals are fulfilled
Research Shows RTCs are Especially Effective Dealing With…
- substance disorders
- long histories of legal involvement
- personality disorders
- eating disorders
- issues with mood issues (bipolar, etc.)
- severe psychotic disorders (schizophrenia, etc.)
- issues re suicidality and self-harm
“If you are a parent and think you have exhausted ‘outpatient’ intervention alternatives, you may need to consider a private residential treatment [option].”
Laguna Treatment Hospital
Precautions to Take When Looking for an RTC
According to the Federal Trade Commission, there is no standard definition for an RTC. They are not regulated by the federal government. And many are not subject to either state licensing or monitoring. It is strongly recommended that the following steps be taken to not only find the right RTC but to protect your teen, your family and your pocketbook.
- Check it online
- Contact it by phone and ask lots of questions*
- Ask for proof of staff credentials, program accreditation, and available endorsements
- Do a site visit
- Get all policies and promises in writing
Licensed by the state?
Which accreditation agency (JACHO, COA and/or CARF)?
Director and staff credentials?
Experience of staff?
Success rateand how measured?
1 “How Do I Choose a Residential Treatment Center?” Good Therapy staff.
2 “Residential Treatment Programs,” Laguna Treatment Hospital.