Levels and level-based systems induce high levels of stress in the patient---obviously.
They work by putting the child in an unbearable situation, and taking some of the unpleasantness away at each "level" of compliance with the program requirements to fake sanity.
The child *does* learn to fake sanity, usually. Usually very effectively.
1) the *last* thing you want to do to a depression psych patient is *add* stress to his/her life.
2) teaching them to "fake good," habitually, and not trust parents and mental health professionals to let them know something is wrong, and *what* is wrong, is terribly, horribly dangerous. It courts suicide by making a patient who is actively planning suicide perfectly able to conceal all signs until you come home and find him/her dead.
I would *not* believe this of a level based program where the base levels were not living conditions significantly below what the child is used to as "normal"---unpleasant, stimulus-impoverished environments that stress the patient.
If you had a level-based program with a *pleasant* base level and true earned privileges, perhaps it wouldn't be actively harmful.
The problem is that moving house is one of the major stressors on the life stress index, regardless, even in ideal circumstances--which a program isn't.
Walking in gardens, painting pictures, petting puppies, and weaving baskets is a *far* better residential model for a depression patient than the kind of austerity you apply to a kid who's pissed off at the world and treating everyone around him like crap.
Yeah, an austerity program might make a depression patient so much *more* depressed and apathetic that she'd be unable to muster the energy to plan and carry out a suicide, but it's hardly an improvement, because you're giving the kid a new low in the worst case model of what can happen in her life, she'll expect the worse, she'll *want* to be dead, she'll think about it a lot, and as soon as the depression lifts enough for her to carry out her plan (which she'll have learned to be perfectly secretive about), she'll suicide.
Nobody tracks how many depression patients get home from these places and suicide, relative to depression patients that *don't* get sent.
A depressed kid that is actively a danger to herself *needs* to be hospitalized.
But these level-based austerity programs are like pouring gasoline on a fire. Sure, maybe the blast will blow you clear and you'll *survive* it, but it's a damned stupid thing to do.
Timoclea
(Julie Cochrane, BS in Applied Psychology from Georgia Tech, 1990. 8 quarters of Dean's List. Living with early onset bipolar disorder 32 years, from a family with a lot of mental illness, mother of a bipolar child. I'm not an expert in the field of clinical psychology or psychiatry, but I'm not exactly your average layman, either.)