Sue Scheff: Teen Help - 15 Tips for Residential Therapy for Teens

Just when you think you know it all, enjoying your time with your baby, that turns to a toddler, that becomes a little girl/boy – then the teen thing can hit when you least expect it!  How do I know, because it happened to me!  I was at my wit’s end when I struggled through a bumpy time with my daughter.  Thankfully, that was almost a decade ago, but some things don’t change – and that is teenagers!


If you have discovered your teen is escalating out of control and you need to find outside help, take the time to do your research and find the best program/school for them.  The teen help industry is a “big business” and if you are not careful, you could get stung.

I have compiled a list of tips when looking at different options.  My book, Wit’s End, can offer much more.  Also visit my website – www.helpyourteens.com for more instant information.

1. Can I speak with the program’s owner, director or therapist? Avoid desperate salespeople, who may be tempted to advise you based upon a commission. You must politely but firmly ask to speak only to the program owner, director or therapist. If the art of remaining calm but also remaining focused and determined while you speak is difficult for you, then please reassure yourself with the knowledge that you are not responsible for whether they feel irritated by your persistent questions. You are responsible for a family member who probably does not know it, but needs your immediate and direct intervention as their last and best lifeline.

2. Does the program provide a parent reference list? If your program representative is able to give you assurances that make you feel comfortable about its suitability for your child, you will probably be provided with a reference list of parents who have or who have had children in the program. If not, ask for it! It is always beneficial to speak with those parents, but remember that since the school gave them to you, they’re most likely to be positive references. You are searching for impartial information to help you make a life-changing decision on behalf of your troubled child. Ask each parent how long his or her child was in the program. Look for a general average. This little detective game takes patience, but these may be some of the most important questions that you ask in this whole process.

An excellent question to ask all reference parents is: If you could change one thing about the program, what would it be? This can be very telling and also bring out some of the negatives. Remember, there are no perfect programs, but if you go in with your eyes wide open, chances are you will be ready for anything.

3. Is the program state-licensed and accredited academically as a school? This is a simple one. Both answers should be yes. Ask to see a copy of their license and accreditations. Check the date to confirm that the license is still valid. If you have questions regarding the license, contact the State Department of Licensing to confirm that the program is truly in good standing.

4. What are the program director’s credentials? Review the director’s educational background (the level of degrees he or she holds), as well as how long the director has been employed by school and his or her experience in the teen-help industry as a whole. Also verify:

• How are the staff members trained and certified? Are staff members certified to physically handle a child without harming him? Is the staff certified in CPR?
• Are the teachers and therapists licensed in their professions? Inquire about the educational backgrounds of the teachers and therapists. Do they meet your needs?
• Does the program run background checks on staff members prior to employment? Child predators typically seek out jobs that allow them greater access to children, so this is imperative to know.

5. Will I be able to speak with my child? How often? Can I visit my child in person? By video conference? And when?  Will my child’s postal mail be monitored or censored, going out or coming in? If so, why?  Don’t settle for glittering generalities, such as telling you that the child will be allowed to communicate once they “reach” a given level or position. If they say that, you should realize that it is then easy for the program to use that restriction to manipulate the child’s ability to communicate with home at all. In most schools and programs, we find that the answer you should shoot for is that they want about three weeks before you have your first phone conversation with your child.

6. What types of financing are offered? Are there scholarships? Also ask: Are there any extra fees that are not included in tuition? Specifically, what are those extra fees, and when must they be paid? Will my personal insurance cover any of these costs?

7. What is the average length of the stay for the students? Do they offer an aftercare program or a transitional program Is there a fee for aftercare? And can my child go back to the program for a second time if he is struggling again? The length of time ranges from about six months at a minimum to as much as two years in more extreme cases. An average length of stay will be within nine to twelve months.

8. What is the average student age in the program? What is the population capacity of the program, in terms of how many students the program is licensed to accommodate, and how many are currently enrolled there? And what is the student to staff ratio?  It is so important that your child be placed in the appropriate element, both in terms of age and gender, and also in terms of not being lumped in with dangerous others. This is one of the reasons that staff-student ratios are so vital. If the staff is too heavily outnumbered, then it will not matter if they are well trained and dedicated in their work. They will be overwhelmed by the workload, and your child will not only suffer the neglect, but be in harm’s way if left unguarded among kids who may be prone to violence.

At P.U.R.E., we have found the ideal student-staff ratio to be between one-to-four and one-to-seven. This range has shown itself to be reasonable, and if the staff is well-trained and supervised, it is a sufficient ratio to maintain order and administer the daily program.
9. Does the program offer open enrollment? This is a vital service. When your child is in crisis, you want to be able to deliver the child immediately. A school that offers enrollment at set times or by semester or around holidays is not a school for troubled teens. Aside from the program’s weekend status, some will only offer enrollment at certain scheduled times of the year. You will generally find that traditional boarding schools and military schools tend to have enrollment periods limited to the structure of their school term.

10. Where is the nearest medical facility and/or full hospital? Does the program have a physician or registered nurse on staff and on premises?  Does the program accept kids on medication? If your child is on prescribed medication, who will dispense it and how will it be monitored? Is there a system in place to monitor the safety and effectiveness of the prescribed medication? Does the school meet your child’s specific medical needs? For instance, if your child is insulin-dependent, physically challenged, has asthma or a severe food allergy, is the school equipped to administer proper care for these conditions?

11. Are they academically accredited? Will the child’s school credits transfer back home? Also find out, if applicable: Do they offer S.A.T. and A.C.T. testing? Do they offer special educational help? As icing on the cake, do they offer any form of extra-curricular activities? Are there extra fees for special tutoring and/or extra-curricular activities? Do they offer college courses or vocational training for older students? Before signing over your child to their care, get a copy of both their accreditation and their school program. Do not allow anyone to make you feel as if you are digging too deep when you check these things out.
These questions are the only way to assure that the child’s education will not be unduly sacrificed during their time in the Residential Therapy program. Just because you are willing to accept that some degree of slip must be reasonably allowed, given the circumstances, does not mean that educational concerns ever go out the window. This is always done with an eye for the day that the child returns home and must begin reintegration into daily life.

12. Does the program accept involuntary enrollment? Will they accept enrollment from kids who have to be professionally escorted there in order to show up? Does the program offer escort services?  What is their policy on expelling a child? Do they allow court-appointed children in the program? You need to ask about this regardless of the state of your child’s behavior because it also tells you about the environment that he or she will be in If the environment around them is not corrective, but simply restrictive and depressing, where are they supposed to acquire the missing ingredients for acceptable behavior, regard for others, and self-esteem?
13. Is the facility secured? Fenced? Also ask: How do they keep the kids from running off? When it comes to personal restraint, what methods does the program employ? Ask them what their policy is in dealing with a student who is completely lost in a rage, perhaps out of control and threatening himself or others. What is the program’s policy about consequences if the students don’t follow the rules? Most schools have time-out areas, but they should not be scary isolation rooms, and the program should never employ isolation boxes. Threatening the child’s fundamental sense of personal safety is counter-productive. It is my belief and experience that doing so builds resentment, anger, and anxiety.

14. What about the physical place itself? What is the housing like? In an ideal world, parents would be able to visit several schools/programs before making a decision. But, realistically, whether due to time constraints or financial reasons, many parents simply cannot make the visits. If you fall into this category, don’t feel guilty about it as long as you are doing your due diligence to research the school. By speaking with parents and possibly former students who have attended, you should get a good sense of where you are sending your child. Most programs welcome visits prior to placement. If they don’t, I would definitely hesitate considering that school.

15.What exactly does the contract entail? If your child is expelled from the program, does the contract release you from financial obligation for the duration of the program? Does the contract outline the costs you are aware of and the services you have been told? Be sure that you are aware of the fees that can be charged to you. In other words, confirm that what you have been told is covered in the contract.

Use the “Instinct Test”: Visit the school. From the moment you arrive, what does your intuition tell you? We each have an innate “parent meter” that goes off and lets us know if something doesn’t feel right. Listen to it! I wish I had. What are your first impressions about the general atmosphere of the place? How do you feel when you get out of your car? Of course, there is apprehension, but is there a sense of security, kindness, nurturing–or do you feel cold and fearful? Usually from the moment I step onto a campus, I can get a vibe, good or bad. In some cases, it is not so good, but after the initial ice breaks, I realize the beauty within.

Remember, this is not easy and not natural, so be prepared for many emotions. But in the end, let your head and heart combined make the decision. People who make it a point to visit a number of these places consistently confirm my own observation that there is a dramatic difference in the general feeling from one place to the next.  Take note if you sense a cold and unfriendly atmosphere, and be sure to note the difference when you walk into a program where the feel of the place is warm and nurturing right from the beginning. Assuming that the two places are equally competent at handling their security issues, which place would you want for your child?

If we can offer our struggling teens an opportunity to find themselves again, the long and difficult journey will have been worth the effort. We can’t look for guarantees; the staff and the students are all human and fallible. But as parents, we can take pride in knowing that during this vital transitory time of our teens’ lives, we have taken every available step to help them build a future–and a self–of which they can be deservingly proud.
I want to thank Michele Borba, Parenting Expert, for also sharing my tips and posting my information as a guest Blogger.  Don’t miss her fantastic book, Big Book of Parenting Solutions, it is a must have for every parent. From toddlers to teens, Dr. Borba covers it all!

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