Insider’s Guide: How to Pay for Therapeutic Boarding School (2017 UPDATE)

Before we dive into understanding the options for paying for a Therapeutic Boarding School, let’s quickly review what they are.

The Rise of Therapeutic Boarding Schools

Image result for boarding schoolAs public schools across the country have slowly been pruned back by state legislatures, funding for behavioral, emotional and academic support within schools have nearly dried up while public money is increasingly being used for private charter schools. Therefore, it’s not surprising private institutions that offer therapeutic (or quasi-therapeutic) environments like boarding schools and private schools have exploded. One of the fastest growing kinds of boarding schools is what’s called a Therapeutic Boarding School. Therapeutic boarding schools maintain the advantages of traditional boarding schools such as intimate class sizes, individual attention, great academics, developing student self-reliance, and the fun of living with peers in a completely “child-friendly” environment.

Some therapeutic boarding schools specialize in helping teens overcome certain psychological problems such as Attention Deficit Disorder, Bipolar, Asperger’s and even Depression. Others have programs for overcoming substance abuse problems or achieving weight loss. Some specialize in helping students who lack motivation get a fresh start in a nurturing environment. Most have some sort of family or parent involvement piece to ensure a team approach (ie. Weekly family therapy via phone or Skype).

While this all may sound great, there are definitely some risks and downsides (beyond the financial cost) of sending a kiddo off to therapeutic boarding school. I address those issues in great detail in another blog post. For now, let’s revisit the financial aspects…

Expense or Investment?

Parents often find themselves in a desperate situation with a troubled teenager. Their daughter runs away from home again, gets caught with the dealer down the street, crashes another car, and has yet another arrest. Parents become afraid for their teen’s lives as their teen’s risk-taking and lifestyle keeps becoming more extreme as the parents’ ability to set boundaries and expectations seemingly erodes.

It’s hard to think clearly and find solutions at times like this. Therapeutic boarding schools and therapeutic wilderness programs can provide answers, but they come at a price, with some programs running upwards of $50,000 a year.

But cost doesn’t have to be an insurmountable obstacle in getting your teen the help they need. We have helped countless parents in similar situations come up with creative ways to finance therapeutic boarding school, knowing that their child desperately needs an intervention. Therapeutic boarding schools are no longer exclusively the domain of the wealthy.

Top 10 Ways to Pay for Therapeutic Boarding School

Image result for therapeutic boarding school

Here are 10 ways families just like yours found to finance their teen’s therapeutic program:

1.   Hire a Consultant: Say what? More money? Yes, but trust me, this really will have super high ROI. Also referred to as case managers, therapeutic placement consultants or educational consultants, a good one is worth their weight in gold (a bad one is expensive and makes bad treatment recommendations). Make sure they are UNAFFILIATED with any program and have the clinical expertise to help advise and guide your family through the whole process. Some clinical educational consultants that specialize are able to handle this. A great case manager will be able to create a treatment plan, explain the process for getting a comprehensive psychological evaluation, walk with you through the intake process, support you while your teen is in the therapeutic boarding school, and coordinate discharge planning to ensure a seamless transition back to home or college. The last piece is essential – making sure your teen has everything they need to succeed after they return. Great case managers also know how to secure reimbursement from insurance providers for teens that attend therapeutic boarding schools. There are definitely some tricks (eg. Hire a case manager that’s also a licensed professional counselor and much of their work could be paid for by insurance) and inside knowledge necessary to make this happen.

Typical cost: $95 – 350/hr (some charge a flat fee of several thousand). 

2. Find the Program’s Financial Aid Officer: The private school or wilderness program should have a financial aid officer who can advise you about how to finance your child’s education. You should ask this person what programs, loans, discounts, or financial aid the school offers. Find out exactly what is included in the tuition and board bills, and if there are additional expenses such as buying uniforms or paying special fees for sports.

Typical Cost: Nothing – programs provide this to try to entice you into signing up. Beware of anything that sounds too good to be true – verify any claims they make about coverage from insurance, student grants/scholarships or loans. 

3.  Public School Funding: You may qualify for a loan through a kindergarten through 12th grade educational loan program. These loans work the same way as college loans, in that you pay what you can while your child is enrolled in the private school, and pay the rest off later. The terms of some loans let you spread out payments over 10 or 20 years. Your credit history will be a factor in securing a loan. Your school’s financial aid officer should be able to help you find such a loan.

Typical Cost: Your sanity – they will drive you crazy with the bureaucracy and take loads of time during your work day since everything in public school shuts down by 3:30pm. 

4.  Discounts for Upfront Payment: Some schools offer discounts if you pay by the year, instead of by the month. The average student stays at a therapeutic boarding school for less than two years, and wilderness programs are even shorter. A good therapeutic placement consultant/educational consultant will save you thousands of dollars by negotiating these discounts.

Typical Cost: More money upfront but no other associated costs. 

5. Tap 529: Consider using your child’s college fund first. Think of the therapeutic program as a way to get your child back on the right path toward college. Without intervention, she won’t have the grades or motivation to get through college and use her fund.

Typical Cost: Make sure there are no withdrawal penalties for use for therapeutic boarding school. 

6. Put it On Plastic: When you enroll your child in these therapeutic programs, there will be upfront expenses such as processing fees and deposits. Some parents borrow these initial payments from credit cards, especially ones that offer “frequent flier” miles. This way their child is immediately enrolled. They use their free mileage for transportation to and from the school.

Typical Cost: Beware of high interest rates if you don’t pay off your balance in full. 

7. Angel Investing: Some parents borrow the necessary funds from employers or relatives, and pay them back after securing educational loans or home equity loans.

Typical Cost: If you go through a peer-to-peer or crowdfunding site like The Lending Club or Kickstarter, count on a 5% fee for total amount funded. 

8. Health Insurance Reimbursement: Your health insurance policy may cover part of the cost of a therapeutic program as a medical expense. When you hire a case manager, they will be able to tell you how to file the paperwork and what you need from the program to ensure a speedy reimbursement.

Typical Cost: Sanity… totally lost if your insurer are jerks that don’t reimburse when and how they should. You are attempting to pull money from their cold, dead hands. Expect a fight.

9. Consult Your CPA: Some expenses for therapeutic schools and wilderness programs can be deducted from your income tax return as medical expenses. If you own your own business, you likely have WAY more creative options for deducting medical expenses.

Typical Cost: $200/hr for a good CPA to walk you through if and how to deduct from taxes.

10. Tap Home Equity: Parents have taken out second mortgages or home equity loans and then deducted their interest payments on their income tax returns.

Typical Cost: Fees, closing costs total 2-6%. It also bumps the timeframe for paying off that home back several years.

11. Public School Funding: We lied – there turns out to be 11 ways to pay for therapeutic boarding school. Is your child enrolled in public special education classes because of problems like attention deficit disorder and learning disabilities? Does your child have an “Individual Education Plan” at a public school? Do you suspect your child has learning problems that the public school cannot address? In certain cases, public school districts have to reimburse parents for private school tuitions. The Supreme Court ruled on June 22, 2009, that an Oregon school district had to reimburse a family for private school costs because the child in question could not achieve a free and appropriate education within the district. The child had not been enrolled in special education classes but was diagnosed later with attention deficit disorder.

When it comes to what matters most parents are unstoppable in finding ways to get the services and support they need. Don’t let cost be the determining factor. If your teen needs help, speak with a case manager, your trusted CPA as well as a therapeutic boarding school you’re considering and work together to find a way to get your teen back on track.

Insider’s Guide: Educational Consulting and Therapeutic Placement

It was warm, breezy day in the little cove where the treatment center was located where my client and her parents were standing. We were all on the back deck of the main building and the parents and I had just arrived. The client smiled after a few minutes of small talk and said, “Um, not to be rude or anything, but who are you?” Her parents looked mortified and embarrassed that she didn’t know who I was.

“My name is Rob Danzman and we’ve met several times before you came to treatment. I helped your parents find a healthy place for you.”

The client, after pausing for a second smiled again and said “I think I was so high I don’t even remember you. Thank you.” She started crying. Her parents started crying and they hugged.

There is a deep and broad gap between what families need and all of the treatment options available. There are a ton of variables to consider when your son or daughter need treatment, whether its outpatient therapy or residential treatment. Insurance, location, modality, diagnosis, and housing options are just a few things families need to consider when figuring out what’s best.

There is a dramatic range in expertise and costs and they are not often aligned. Some of the most expensive consultants with whom I’ve worked have minimal understanding of psychological conditions and the evidence-based approaches that best treat them. The goal of treatment is either assessment, intervention or maintenance of a behavioral health issue. If a consultant does not have a combination of academic and experiential background they may not serve clients well. In fact, my agency has worked with clients who were given terrible advice on what types of service to use. You would never have a mechanic give advice on spinal surgery because, while the mechanic may be really well-intentioned and personable, they may due considerable harm. The same is true when dealing with behavioral issues, many of which either in the short or long term may have life and death implications.

Evidence-based interventions need to be well understood and require clinical expertise. Therapeutic placements do a great job of presenting themselves as comfortable, safe and a good value yet many do not provide evidence-based treatments. Evidence based treatments are not for broad spectrum of psychological issues.

Another confusing aspect is the terminology. Decades ago, educational consultants did a few things and did them well – they focused on private school and college prep admissions. They provided deep advice on testing strategy, applications, and how to write a great essay. They coached clients through interviewing and often the whole education process. But over the years, ECs expanded their service offerings, often outside of their area of expertise. ECs without credentials or appropriate degrees started advising parents on treatment recommendations, presumably assuming that applying to a treatment center is similar if not the same as applying to college. Since those wild-west days of ECs pushing kids into cookie-cutter programs and charging a fortune, more clinicians with actual therapeutic experience have entered the EC world. Granted, there is still the old guard of older, white women who had their own children placed in a treatment center and saw an opportunity to help other families while making good money in an unregulated field. There are essentially only one entity that oversee ECs – the Independent Educational Consultants Association. The division continues to widen between those serving families

EC should not receive gifts from treatment centers though it’s not unusual for them to have travel expenses covered when they are touring programs.

There is a symbiotic relationship between treatment centers and ECs. Treatment centers count on ECs for referrals. ECs count on treatment programs to cover travel expenses and, sometimes, provide referrals back to the ECs when a client needs a different placement or the family needs advice on treatment options.  

Where to Find These Magical Beings

First thing to do is just google the terms “educational consultant” and “treatment.” You should get plenty of options that pop up. You could also just contact my agency but I’m a bit biased since I believe we do great work for a fair price.

Next way to find a placement consultant is to go to the Independent Educational Consultants Association (IECA) website (below in the Resources section) and look for the ‘Search’ option under the Parents tab. All of the people listed in this resource are paying members of IECA and met the IECA’s criteria. If you are going this route, I encourage you to, at a minimum, look for a consultant who has a graduate degree in a behavioral health discipline like counseling, psychology or marriage and family. Pastoral counselors or ‘Qualified Mental Health Practioners’ are not nearly qualified enough. It’s even better if they are a licensed professional (eg. Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker).

Do Your Homework

A great EC can support your family through the most difficult times while a bad EC can cost your valuable time and money and have nothing to show for it or set things back even further with a terrible placement.

Consult: If you can’t meet them face to face, then schedule a call with them. Before you go into any details, dig into the business end of their service first. Do they offer therapeutic placement consulting or do they focus on prep school and college? What are ALL the costs associated with what they do. What is their degree in and what active licenses do they hold. Ask if they are a member of any associations and if they have any disciplinary actions against them. Ask when and how they got into educational consulting. Ask what the scope of their work is – Do they meet clients at treatment centers for admissions? Do they continue to work with families while the client is in treatment? Do they assist with discharge planning?

Payment: Another thing to consider is how the ED gets paid. It’s important to understand whether the EC sends you an invoice and bills as they go along or do they receive a retainer upfront. Though not a deal breaker, I don’t like asking for retainers from clients for the same reason I don’t like attorneys collecting a retainer from me. They have my money and pull from it as they do work. I’d prefer to pay for things as we go along through a project. We only accept credit cards so that a) there is protection for the client and b) we don’t need to run after clients to pay an invoice. We also itemize every time we charge a client’s card so that everything is 100% transparent. Ask about how folks get paid before you agree to work with them. If they can’t agree to provide itemized billing or seem too focused on money upfront, you may want to consider working with someone else.

Guarantee: It’s unlikely anyone is going to offer you a guarantee for their services but it doesn’t mean you can’t ask about their responsibility if a treatment option doesn’t work or a treatment option can’t be found in a reasonable amount of time.

Cost

Take a deep breath for this section. Expect to pay between $10,000 – $300. Yes, I know that’s a ridiculously large range but there are no regulations on what an EC can charge. The spectrum of fees is truly that big. Some charge as much as $10,000 for a placement. They may put in 5-10 hrs but their rate doesn’t change. Other ECs charge a lower rate but most have a basic flat fee which covers support and advice through the admissions process. In my humble opinion, a lower flat fee or hourly rate is more fare. For instance, my agency has a free consultation to determine if someone really needs an EC. If we determine the client really can’t find an appropriate treatment option on their own, we charge $179 per hour and use as few hours as possible. We’ve had client come to us after spending $25,000 on placement services only to realize the ECs they were using had no clue about severe clinical issues like substance abuse and schizophrenia. Fortunately, we quickly found them services and billed them less than $500.

FAQ

Q: I know how to do internet researching. Why can’t I just find a treatment program on my own?

A: You could totally do this own your own. There are three easy steps. First – get a graduate degree in some counseling or psychological discipline to learn the clinical aspects of behavioral health and intervention. Next – work in the behavioral health industry for about five years so you can see what makes a program great and what makes a program terrible. Finally – go and visit 50 treatment programs. Granted, that will take a few years, and by the time you’re finished visiting, staff at each program will likely have changed (so start over). Ultimately, this experience  will be very helpful in determining which programs are good and which ones you would not trust to take care of your house plants. After all these steps, you should totally do some internet searching to decide which program is most effective at serving your loved one.

Resources

Independent Educational Consultants Association – https://www.iecaonline.com/

The Menninger Clinic Video

 

Here is a short promo video from the Menninger Clinic in Texas. They are an inpatient psychiatric hospital that specializes in treating individuals with complex mental illness, including severe mood, personality, anxiety and addictive disorders. Learn more at http://www.menningerclinic.com/

Definition: Education Consultants, Case Managers, and Therapists oh My!

Those of us in mental, behavioral health and substance abuse fields generally know the difference between all the different professionals that support individuals and families. Unfortunately, we don’t always do a great job of helping clients understand the differences (and similarities). So, without further explanation, we present a humble attempt at defining professionals you may come across.

Educational Consultant: Also known as E.C.s, educational consultants started out decades ago helping families get their kids into college, private school and boarding schools. As family needs changed, so did E.C.’s focus. Nowadays, E.C’s serve families looking for academic advice and placement recommendations. In times of crisis, parents are often overwhelmed by a barrage of emotions, options and information. The confusion and desperation associated with having a struggling teenager or child can be extremely difficult. Parents may not be aware of the choices available, or may not be able to decide on their own which alternative best meets their situation and the needs of their child. Among the questions consultants often hear: How do we know when treatment is necessary? What would be best for our child? Is an intervention needed? Should we find a residential program? Would a wilderness therapy program be a good choice, or would an emotional growth boarding school be better? There is no one certification or academic program for educational consultants. Their quality and experience span a huge continuum.

Case Manager: Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes. Basically they specialize in the organization and treatment planning for families that need finding a treatment program or need help transitioning their child back home. Educational Consulting is often a part of good case management. Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source. Case management services are best offered in a climate that allows direct communication between the case manager, the client, and appropriate service personnel, in order to optimize the outcome for all concerned. Not unlike E.C.’s, Case Managers do not require certification or specific academic credentials but are often clinicians with at least a Master’s degree in a disciplin like counseling, psychology, social work or marriage and family therapy.

Therapist: A therapist is a general term for counselors, psychologists, psychiatrists, psychotherapists and psychoanalysts. They are trained professionals that treat mental and behavioral health and substance abuse problems through talk, discussion and interaction. A therapist helps clients you learn about conditions and moods, feelings, thoughts and behaviors. Therapy helps the client learn how to take control of one’s life and respond to challenging situations with healthy coping skills. There are many specific types of therapy, each with its own approach. The type of therapy that’s right for a client depends on their individual situation. Therapy is also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.

Check back next time when we talk about Counselors, Psychologists, Psychiatrists, Social Workers and Clinicians. Got a clinical term you’re confused about? Contact us and we’ll post info on it. More than likely, you’re not alone in your confusion.

 

5 Things Your Education Consultant/Case Manager Should Be Doing Right Now

This is our raw, irreverent guide on what in our humble opinion education consultants and case managers should be doing right now to provide the highest quality service to you. This list is valid regardless of the type of mental, behavioral health or substance abuse treatment you or your loved one is receiving (eg. therapeutic wilderness program, therapeutic boarding school, individual outpatient therapy, psychological assessment). If you go through the list and your well-compensated professional is providing you with anything less than what we discuss below, copy and paste this into an email and let them know you’ll keep them hired only if they get on board.

1. Consistent Contact

When we first started Fonthill, we were so focused on accomplishing all the goals and objectives we developed with parents and families that we failed to keep everyone informed and on the same page. We learned from our mistakes that weekly contact (at a minimum) is essential. Your education consultant / case manager should be providing you (and the whole team) with regular email or text updates. These are not updates you should need to respond to, just information letting you know an application was submitted, insurance claim was accepted or that the psychologist doing your son’s assessment will be available about 30 minutes earlier if that works for you. Parents count on us to keep them informed.

2. Proactive Planning

Here is another mistake we made. Our teams are experts on working with behavioral acting out, crisis, intervention, parenting, and families but what we quickly learned we needed to do just as well was developing a treatment plan that included more than just what the parents thought was the issue. We expanded our planning WAY beyond what we estimated our involvement to be so that after we had worked ourselves out of a job (…another hallmark of good work) the family had a set of instructions, a road map, a guide if you will on who should be doing what and by when. Make sure that your education consultant / case manager is developing a plan that considers the big picture since treatment and life do not stop when the professional’s final payment is received. Seriously, they should be mapping out way far into the future to mitigate obstacles and pot-holes you are not even thinking of (eg. Financial literacy for your son entering substance abuse treatment).

3. Saying ‘No’

A really good way to determine if your education consultant / case manager is worth their weight in gold (…or Rhodium) is how often they say ‘no’ to 1. New Clients, 2. Current Clients and 3. Professionals on your team.

Let me explain. New clients – We make it very clear to perspective clients that not everyone that contacts us becomes a client. We could become the Wal-Mart of family services but quality would go WAY down. Education consulting, case management, family counseling and our parent education and consulting would become commodities. Many desperate professionals say ‘yes’ when leads are low and expenses are high (…McMansions are cheap ya know). Current clients – A really valuable and important education consultant and case manager is hired to set a course, develop a plan and make sure the heading if followed. Parents often, with the best intentions, attempt to deviate from the course when kids get unruly or their own fears start to percolate. Professionals – One of  our most important jobs as case managers is working out issues behind the scenes (eg. Setting a limit on the ‘add-ons’ a program may want to push on parents). Being able to effectively and respectfully say ‘no’ to other professionals is an essential skill that should be in your case manager’s repertoire.

4. Billing Fairly

Have you ever lost your mind when you looked over your hospital bill from the Cedars-Sinai Medical Center that showed that the Aspirin they gave you cost $1000? Yeah, we don’t like that either. We think billing should be fair and transparent. There are many, many families that we work with that make a bazillion dollars. There are also just as many families that are have very modest incomes. We charge the same for them all and we are upfront with our costs. We also don’t think it’s appropriate to gouge our clients with ridiculous initial consultation fees ($5,000 for an initial meeting? Get real.) We also don’t like contracts for X number of months. Life happens and we know families sometimes need to make drastic changes. Being on the hook for a service that’s supposed to solve problems and not create new ones is important to consider when signing up with an education consultant  or case manager. We recommend the shortest term necessary with flexibility built in. For instance, rather than expecting payment everytime we meet, we invoice clients monthly for the work completed (…not for the upcoming month like a landlord). Make sure you understand your bill and that all the expenses are for things you agreed to.

5. Maintaining Boundaries

Oh this one really gets us frustrated. To be able to have the healthiest working relationship with your education consultant and case manager they should constantly maintain professional boundaries similar to Licensed Professional Counselors – No dual roles (eg. Your professional is not also your CPA) and No merging of personal/professional relationships (eg. Your professional is not discussing non-work related issues). This may seem like small stuff but, think about it this way. You hired this person to provide objective analysis and recommendations to advance your family through some obstacle. This creates what in mental health parlance is referred to as a power differential. A power differential is when one party has greater power than the other (eg. Judge vs. defendant). In this case, the professional has power over the parents because the parents are in a vulnerable position, meaning they are counting on advice, but also relying on the professional to protect their confidential information, reputation as well as their emotional and psychological health. If your education consultant has crossed any line that’s not clearly stated in their scope of service, consider talking with them directly and asking them to respect the professional relationship you want with them by limiting the personal sharing and interaction. It may feel uncomfortable, but consider this – what happens if you are not happy with something they did? What happens if the treatment program they recommended turns out to be crap? It’s much easier to confront someone who has maintained professional boundaries throughout the process.

This list is not exhaustive but a starting point to ensure you have some reasonable expectations of what to expect in your relationship with an education consultant/case manager. Contact us at Fonthill if you need more help or if you’re not sure how to best use your current professional support.