Ensuring the preconditions for transformation through licensing, regulation, accreditation, and standards.

Abstract

Residential treatment is a potentially powerful intervention for children and families, currently facing the imperative to fundamentally change practice models to achieve greater quality efficacy, efficiency, and effectiveness. Such transformation is best accomplished from a solid foundation which is created by licensing, regulation, accreditation, and internal standards.

Preliminary Data from the NATSAP Research and Evaluation Network: Client Characteristics at Admission

“…These noble concerns have led to the recent formation of the The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) (Friedman et al, 2006) to government studies (Kutz & O'Connell, 2007), and to proposed regulatory legislation (HR 911: Stop Child Abuse in Residential Programs for Teens Act, 2009). Much of this recent activity has focused on the potential harm of "unregulated" programs and has involved a push for the licensure, accreditation, and government oversight of programs (Friedman et al, 2006;HR 911: Stop Child Abuse in Residential Programs for Teens Act, 2009;Lieberman & Bellonci, 2007).…”

“…Such dynamics have fostered intense criticism and scrutiny of residential programming (Frensch & Cameron, 2002;Leichtman, 2006;Pumariega, 2006;Whitehead, Keshet, Lombrowski, Domenico, & Green, 2007;Zimmerman, 1998). For example, public concern for ethical treatment of youth in residential treatment has led to recent publications and policy initiatives calling for increased accountability and oversight for residential programming (Friedman et al, 2006;HR 911: Stop Child Abuse in Residential Programs for Teens Act, 2009;Lieberman & Bellonci, 2007) One specific subset of residential treatment for youth in the North America consists of privately owned programs where the majority of the cost of treatment is paid for by families without the reimbursement or support of third-party payers. These "privatepay" programs fill the needs of families who are not part of publicly funded social, mental health, or juvenile justice services (and may not want to be); whose insurance plans do not cover residential treatment; and who are not succeeding in treatment with either hospitalizations or out-patient clinical services (Friedman et al, 2006;Leichtman, 2006).…”

Adolescent Substance Abuse

“…The top programs were not more likely to be accredited than others. Contrary to this finding, Lieberman and Bellonci (2007) provide argument for the value of licensing, regulation, accreditation, and internal program standards in efforts to obtain more consistently positive results with residential treatment.…”

A Practical Guide for Implementing Evidence-Based Assessment in a Psychiatric Residential Treatment Facility: Translating Theory Into Practice

“…Considerable debate continues, however, regarding the quality, standardization, and cost-effectiveness of the mental health services provided by PRTFs (e.g., Burns, Hoagwood, & Mrazek, 2005). For instance, what constitutes "treatment" in PRTFs varies widely (Leichtman, 2006) and facilities are typically not required to meet specific licensing or accreditation requirements (Lieberman & Bellonci, 2007). The lack of such oversight also decreases the amount of supportive infrastructure that would otherwise assist PRTFs in setting up and implementing Evidence-Based Assessments for PRTFs 213 a system that utilizes evidence-based practices (EBPs), 1 including evidencebased assessment and treatment protocols.…”