CHILD WELFARE MANUAL

4.4.9 Residential Treatment

This placement resource should be considered for children who need structured and therapeutic intervention provided in a residential treatment setting. Placement in a residential treatment facility must be time-limited and treatment focused so that the child can transition to family and community-based care as soon as possible:

  1. Residential Treatment – level II/moderate level may best meet a child’s needs if:
    • Child has mild to moderate social, behavioral, educational, and emotional problems;
    • Child is in need of a diagnostic assessment;
    • Child needs assistance in educational, religious, recreational, and/or socialization experiences;
    • Child displays behaviors such as running away, school truancy, incorrigibility, sexual misconduct, drug experimentation, physical displays of intense anger, verbal or physical abuse toward authority figures;
    • Child is of average intelligence and exhibits adequate responses to reality testing, and can function in a regular or alternate community school or can benefit from on-site tutorial or educational services where available;
    • Child needs structure and supportive services not available in a foster family or foster family group home;
    • Child is emotionally disturbed and his/her past experience is such that he/she is unable to maintain in a foster family or adoptive home; and
    • Child is in need of more structure, but still can function in an open environment where he/she can be studied and observed by the child care staff, Children’s Service Workers, psychiatrists and psychologists, and where a diagnosis can be made and treatment plan can be developed and implemented.
  2. Residential Treatment – level III/severe level may best meet a child’s needs if:
    • Child’s emotional disturbance is so severe as to require comprehensive, intensive treatment and services, i.e., severely aggressive, chronic enuresis or soiling, chronic running away, fire setting, sexually acting out, bizarre sexual behavior, chronic truancy, incorrigible, drug usage, suicidal gestures, chronic nightmares, extreme temper tantrums, severe relationship problems;
    • Child is depressed, has low frustration tolerance, neurotic and personality disorders, psychosomatic illness, retarded emotional development, mild or severe forms of anorexia, and thought or affect disorders, (i.e., jumbled speech pattern, inappropriate response);
    • Child is a danger to self or others, or is severely withdrawn;
    • Child cannot function in a public school setting because of his acting-out behavior and/or severe learning deficits;
    • Child needs extensive professional help in areas of social skills, learning skills, and/or motor skills; and
    • Child exhibits behaviors that require a highly structured setting providing intensive treatment services.
  3. Residential Treatment – level IV/intensive may best meet a child’s needs if:
    • Child was previously receiving care in an acute care hospital, but does not currently need inpatient psychiatric treatment; or
    • Child is demonstrating treatment needs which require the following services:
      • Psychiatric supervision and review of the child’s individual treatment wherein the psychiatrist has personal contact with the child no less than once every 30 days;
      • Treatment encompassing a coordinate plan using, at a minimum, group and individual therapeutic modalities consistent with the needs of the child; and
      • Classroom education (required by law) provided in a school located at the provider’s facility.

Related Subject:  Section 4, Chapter 18,  Residential Rehabilitative Treatment Services

Chapter Memoranda History: (prior to 1/31/07)

Memoranda History: