Treatment 101: Therapeutic Boarding Schools and Residential Treatment Centers

Today we examine some of the basic differences and similarities between therapeutic boarding schools and residential treatment centers (or programs).

 

THERAPEUTIC BOARDING SCHOOLS

Also known as Emotional Growth Boarding School (not used so much any more), is a boarding school based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with psychological, behavioral, substance abuse, or learning difficulties. Another newer term is Academy which lends some gravitas and impressions of legacy. Basically, it sounds fancier. 

In contrast with Residential Treatment Centers, which are more clinically focused and primarily provide Behavior therapy and treatment for adolescents with serious issues, the focus of a TBS is toward emotional and academic realignment involving clinical and academic oversight for physical, emotional, behavioral, family, social, intellectual and academic development. Therapeutic and educational approaches vary greatly; with the approaches best described as a combination of interventions often based on the founders’ perspective. The typical duration of student enrollment in a TBS range from one to two years with many schools mandating a minimum stay of at least 1 year. Students may receive either high school diplomas or credits for transfer to other secondary schools. Some therapeutic boarding schools hold educational accreditation within their respective states. TBS’s may be for-profit or non-profit entities and might also be owned by a much larger company (eg. Aspen Education Group, Red Cliff Ascent, Universal Health Services to name a few). 

Therapeutic boarding schools are generally middle schools and high schools that have comprehensive therapeutic interventions (medication management, individual/group counseling, life skills) for the students and a program to help them with self-esteem and problem behaviors. Some are more therapeutic than others while some boarding schools are actually therapeutic but will not list themselves in that category to avoid any negative connotation. 

Most of the therapeutic boarding schools do not have a medical plan for bipolar disorder, and do not provide psychiatrists on staff. If you want your child to attend a therapeutic boarding school he or she needs to be stable enough to attend school with therapy support (typically includes individual counseling 1-2x/wk, group counseling 1-2x/wk and 1 weekly phone conference with parents/therapist), while maintaining a relationship with an outside psychiatrist. Additionally, some schools do not wish to administer psychotropic meds. Ask the admissions folks if this is something important for you. 

 

RESIDENTIAL TREATMENT CENTERS

Sometimes the school that best meets the child’s needs just doesn’t exist anywhere near home, or the child may become too unstable to stay at home and attend school. It may become painfully obvious that a change in environment with a twenty-four-hour peer group and non-parental authority figures may help the child grow and mature in a safe environment. Maybe they are a danger to themselves or others and they need to be in a setting that can monitor their illness and behavior, as well as provide them with tools to understand and deal with their illness while not losing ground in school.

Residential Treatment Centers (RTCs) are medical facilities (most of the time). They should have psychiatrists and nurses on staff. They administer medications, make medication adjustments, and provide therapy and schooling. They are required to follow a student’s IEP.

Residential schools can cost anywhere from $56,000 to over $125,00 per year. A school district may pay part or most of the fee of such a placement, but typically only after a due process hearing. This process is not recommended for parents – Definitely bring in professional support for this (yes, a case manager or educational consultant with expertise in IEP/504 process and laws within your state). 

If you have not noticed the theme, here it is – Parents should ask for help from a clinical case manager or educational consultant. While the vetting and application may seem like an easy project for accomplished parents, the timing, financial and clinical complexities can create significant challenges. The case manager should have any professionals working with your child contribute to the discussion on placement strategies and options. Leave this to the professionals. It costs money on the front end but will save you thousands of dollars over months and years and also help you to understand your child, family and the education/psychological process much better. 

Here are some additional resources:

Program Tour: Day 3-4 Oxbow Academy and Discovery Ranch

Here is the second of two part series of my visit to Redcliff Ascent and their sister programs in January 2013.

Day 3 – Oxbow Academy and Discovery Ranch

From Redcliff we went North East. Next was a long, weaving drive through mountain valleys towards  Oxbow Academy which specializes in working with adolescent boys with sexually-inappropriate behaviors. Their two campuses provide the ability to support kids with unique needs rather than having just one big facility. It’s a deeply clinical program with the feel of a safe home-away-from-home. Erin Nester, Admission Director, drove me between the programs so we could talk clinical details about the program. Basically, these folks know what they’re doing and clearly help families that feel hopeless.

After meeting with some extraordinary young men from around the world with the backdrop of snow-crusted mountains behind them, Steve and I slid out the icy driveway and continued our trek North towards Mapleton, UT where, on the sprawling campus of Discovery Ranch, I presented to all the Redcliff sister programs on working with affluent individuals and families. From the moment I went through the front gate to the final good-byes with staff – I felt I had experienced a truly thoroughly-designed and supported residential program. Every detail had been thought of to fully engage adolescents in realigning themselves.

Day 4 – Discovery Academy

I was not prepared for the detail the owners took to preserve the church they refurbished into a cutting-edge therapeutic boarding school. The staff at Discovery Academy maintain important history for the surrounding town while providing cutting-edge therapeutic academic support. The academic professionals, the clinicians, the administrators – all of them, they all show a level of personal commitment to the kids and program at large. The kids that go here are clearly good kids that need a bit of structure, a bit of nurturing, and a whole lot of encouragement to transcend unhealthy patterns.

Summary

I can not recommend any dining options anywhere near Redcliff programs for those of you that appreciate a good meal. Options between some of the programs often pitted us between awkward Chinese food restaurants and the snack aisle in the strangely empty WalMart. And please, do not ask for Starbucks or good coffee. If you can’t bring your own, start adapting to Earl Grey for your morning fix since you’ll either be drinking the brown hotel swill or hot black tar at one of the prolific truck stops. But let’s be real, you’re not looking at a Redcliff program because of the food or drink choices. You’re here because you’ve got a child or adolescent that’s been acting out and needs help. If you’re considering a Redcliff program, you’ll do a bit of traveling … but the investment of time, money and energy will be well worth it. Redcliff and all their programs are full of passionate, thoughtful staff with a full array of behavioral and academic services for teens and their families. They are not perfect and struggle with similar issues effecting other programs. The big difference is their curiosity and sincere interest in being a truly learning organization.

Here is the full list of Redcliff programs: Redcliff Ascent, Discovery Ranch, Discovery Academy, Medicine Wheel, Oxbow Academy, Discovery Connections