Fornits
Treatment Abuse, Behavior Modification, Thought Reform => The Troubled Teen Industry => Topic started by: Antigen on October 30, 2005, 04:09:00 PM
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Ladies and gentlemen (and not so gentle folk), may I bring to your attention a recent chapter of a long and sordid story.
I find myself out of the mainstream, even among ppl who agree w/ me that this industry is one fucked up manifestation of the ugly side of our culture which we desperately need to address. I'm very much encouraged by signs of growing interest in the topic (that, after all, has been my primary objective; to foster and nurture a growth of interest).
However, I find very little comfort in the idea that the regulators have mounted up and are riding to the rescue. Here's why. I can't see any significant difference between the current call for licensing and regulation and the one that started in SW Florida close to 30 years ago.
Here's the New Times copy. http://www.newtimesbpb.com/issues/2004- ... ure_6.html (http://www.newtimesbpb.com/issues/2004-12-09/news/feature_6.html)
I've copied the entire article here, just in case they don't keep it available forever. http://fornits.com/wwf/viewtopic.php?topic=7384&forum=9 (http://fornits.com/wwf/viewtopic.php?topic=7384&forum=9)
Please note that, ever since the early `80's, Straight, LIFE, SAFE and Growing Together have been licensed and, ausensibly, monitored and overseen on a daily basis. Has it done the trick? Are the children currently interred to the tender mercies of the staff and group at Growing Together safer?
I would argue that they're actually less safe, more screwed by virtue of these crack pots' having acquired and maintained their licenses. Many attempts have been made to call them on the carpet for the things they do to kids and families. All have fallen flat, obviously. It always starts out w/ a valid complaint of behavior that, if it had taken place in the home or in public, would be criminal. And it always devolves down to petty bullshit about licensing issues, square footage, whether the confinement is enforced w/ dead bolt locks or 'just' motion detectors and doors blocked by sleeping inmates.
In other words, licensing and regulation don't do the trick. They only distract the public from the ugly, difficult, uncomfortable facts of the matter. And, just like most of us when we were in group were happy to pretend something never happened when Staff called for a song, they're more than happy to focus on the minutae of licensing status and pretend there never was a broken child or disowned parent at the core of the issue.
What do ya'll think?As men's prayers are a disease of the will, so are their creeds a disease of the intellect.
--Ralph Waldo Emerson, American essayist, poet, philosopher
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Hey ginger-
I agree with what you are saying, I've been wondering the same thing- like Provo Canyon is accredited and we all have heard the stories coming out from there...the plan of action, at least what I would like to be a part of is to figure out how to make regulation and accredidation an effective way of preventing abuse. The reason reg. is so important to begin with and they we must go from there, is b/c w/o it we have nothing and can't address the problem. Once we have regulation we can address the problematic aspect of accediting bodies. Like anything else though, one foot in front of the other- baby steps.
I naively thought that reg. would solve everything, but it won't as you point out and it has it's own problems that we will have to contend with when things get to that point.
At least, this is how i see it. It's frustrating for me b/c...progress is so slow and I only recently came to realize how ineffective these accrediting bodies can be- hence Provo and others and what that that will mean in terms of securing the safety and appropriate care of youth in this country. Tons of work ahead of us, everyone...
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btw- if you look at APA ethics, etc, I think you will find that they reflect a kind of care that is absent in what you describe, but is the standard for accredidation. That's not to say it's implemented everywhere, but as I said before and as I see it- there's no reason it should not be. I would be careful confusing the issue- at the core their is a standard and mistreatement is not sanctioned- even if it happens. The ethical treatment of youth is something that should be secured- period. Because it's not by accrediting bodies does not mean that the mistreatment itself is acceptable.
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For example:
While DCF's investigations of Growing Together are less aggressive than they were ten years ago, the state agency continues to find significant problems. During the most recent inspection, on December 19, 2003, investigators discovered documents that suggested staff was too quick to use physical force and that children continued to sleep on mattresses on the floor. State law requires children to have a full bed and frame.
Ladies and gentlemen, this is not a significant problem!!!! Not in the context of this issue, anyway. A significan't problem would be, say, clear, extreme, agrivated harassment 24/7 for months at a stretch. THAT is significant! Can any of you folks who have not been through it yourselves, but have started to catch onto the dirty little deals of this story even imagine what that's like? Try.
You start w/ an open ended intake 'interview' that feels (and is) much more like an interrogation of an enemy combatant. Over the course of hours or, in rare instances, DAYS, you, a teenaged kid, come to realize that there is just no possible way out of that except by signing on to whatever may occure beyond that door. Fact and reason have no currency here and your wishes and opinions are irrelavent. If you disagree w/ the staff's assessment, well then you're just in denial.
And so you sign on w/ your own hand and signature. That, btw, is the first really big mindfuck. That signature has no legal value whatever, having been obtained from a minor under duress w/o legal or even layman counsel. But the kid don't know that (heh!) [just imagine GW Büsh's signature smirk and cackle here] Next stop, the bathroom or maybe another tiny little room for your strip search and piss test.
From that point forward, unless and until you satisfy Group and staff that you accept that you are a druggie in need of radical treatment and that working the Program is your only hope for survival, it doesn't get any better. Honest to God, it doesn't.
Here's how much that can effect people. Different people respond in different ways. I've always been pretty passive.
One time, I had forgotten to pee during the regimented nightly speed drill through the bathroom. I think there were two oldcomers and 3 or 4 newcomers sharing a single little bathroom and in a house out in Osprey w/ sulphur filled well water. Driving from Osprey to Gandy Blvd. every morning and night (including open meeting nights, on which we did it morning and very early the next morning) we were not getting anywhere NEAR enough sleep.
In fact, sleep was what it was all about, everybody relished every spare minute we could squeeze in under any circumstances that would not violate Program rules. The rules pervaded and dominated every aspect of every moment of our existance.
So I wake up in the night with a dire need to pee. I didn't want to wake up my oldcomer to get her to unlock the door. She wasn't getting any sleep either. And, besides, that would have meant she would have to wake up the other oldcomer, to guard against any false moves (in case this was just a ploy in a well coordinated escape attempt).
I didn't hate her, as you might expect. I had had 10 years to learn Program culture and I fully understood that she didn't have any choice, she was just doing what she had to to get through it, just like everybody.
So what would you do? Me? I groped around in the dark for a suitable container, found the top to her very pretty plastic laundry hamper w/ the pretty flowers painted on it and used that. Then I went back to sleep. There was some "discussion" about it in the morning. Next night, same thing happened, only I didn't wake up. Instead, I woke up to the realization that I was in the middle of peeing all over the bedroom floor where I slept and that the whole trip to the bathroom and the toilet I thought I had been sitting on had been just a dream.
Like I said, I really was a very passive kind of kid. I might worry a point of argument to a slow and painful death by boredom sometimes. But, when it came to standing up for myself in the face of conflict, I nearly always defered, held it in and waited for a less stressful oportunity to meet my own needs.
Somehow, that got resolved. I think I just made it a point to pee every chance I got. Took me fully 21 days to bring myself to insist on being given enough time to move my bowels w/ an audience. And I'm not the only one. Funny thing is that, when my oldcomer first noticed how distended I was, she spent at least an hour trying to force me to admit that I was pregnant because I was such a whore. Me? I didn't even know why. I just knew I wasn't pregnant, damn it! LOL
Now, I ask you, what has the licensing and regulation lobby got to offer to remedy that?
Not a place upon earth might be so happy as America. Her situation is remote from all the wrangling world, and she has nothing to do but to trade with them.
--Thomas Paine
_________________
Drug war POW
Straight, Sarasota
`80 - `82
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Sorry, Kat. I hadn't stepped off my soap box when you replied.
On 2005-10-30 13:38:00, katfish wrote:
"Hey ginger-
I agree with what you are saying, I've been wondering the same thing- like Provo Canyon is accredited and we all have heard the stories coming out from there...the plan of action, at least what I would like to be a part of is to figure out how to make regulation and accredidation an effective way of preventing abuse. The reason reg. is so important to begin with and they we must go from there, is b/c w/o it we have nothing and can't address the problem. Once we have regulation we can address the problematic aspect of accediting bodies. Like anything else though, one foot in front of the other- baby steps.
And how well has that worked out so far?
You think we have nothing else? I think you're mistaken, but I don't blame you at all. The only reason I have even an inkling of the other alternative is because I'm old and my dad was older still and he was one of those odd freaks who insisted on questioning every new and modern technology, including (maybe even especially) the stunning advances in social engineering.
The alternative to a regulated or unregulated private teen prison system is... NOTHING! At least, nothing new. Want to protect your kids against stranger danger? Let them all go out and play like we used to. There's just no better way to eliminate the level of seclusion in public necessary to kidnap a kid. And there's no better way to keep tabs on what's going on in your neighborhood than to have a bunch of indescreet children running wild, poking their noses into everthing.
In other words, people (by that I mean the current crop of parents) need to quit stressing and worrying themselves and everyone around them over the typical trials and trevails of growing up. We've been doing it successfully for some thousands of years since we first put stick to soft clay and there's every indication that we, especially we here in America, will keep it up w/ ease for another few thousand years.
We've been taking baby steps for about as long as I can remember. But they seem to be leading in the wrong direction. Instead of preventing abuse, we're codifying the proper, legal way to do it effectively w/o leaving overt forensic evidence.
Immortality: A toy which people cry for, And on their knees apply for, Dispute, contend and lie for, And if allowed Would be right proud Eternally to die for.
--Ambrose Bierce
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On 2005-10-30 13:43:00, katfish wrote:
"btw- if you look at APA ethics, etc, I think you will find that they reflect a kind of care that is absent in what you describe, but is the standard for accredidation. That's not to say it's implemented everywhere, but as I said before and as I see it- there's no reason it should not be. I would be careful confusing the issue- at the core their is a standard and mistreatement is not sanctioned- even if it happens. The ethical treatment of youth is something that should be secured- period. Because it's not by accrediting bodies does not mean that the mistreatment itself is acceptable. "
Yeah, and if you look at the printed rules and espoused dogma of any of the Seed spin offs, it's the same. In print, they have nothing but the highest regard for the youth in their care. Hell, they all started out on front row themselves. But that breaks w/ the reality on the ground (or in the group room, as it were)
Even now, if you're a bit nebish, you can look in on the ongoing argument between me and my brother over The Seed. That's been going on for at least 20 years. He still insists that the Seed was all about love and honesty and honor and all that. He does concede that Straight may have been worse, but only cause he wasn't there to wittness the same tired and weak dogma coming out of the mouths of Seedlings who staffed Straight as he'd heard over on Ft. Lauderdale.
Doesn't matter how abusive the actual day to day treatment of the captives, so long as they can make it look good on paper.
No, I don't have any faith left in regulation, legislation or litigation to make this situation any better, EXCEPT one thing. That thing is that regulation, legislation and litigation are the national passtime. If you want people to think about an issue and respond as they see fit, those are the next best ways to make that happen after direct appeal to the IVth Estate. That's what I'm banking on; the media, all of it, from satire to legally defensible documentary. Education (rampant talking out in group) is the key, I'm convinced of it.
Why should we take advice on sex from the Pope? If he knows anything about it, he shouldn't.
--George Bernard Shaw, Irish-born English playwright
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On 2005-10-30 14:45:00, Antigen wrote:
"
On 2005-10-30 13:43:00, katfish wrote:
"btw- if you look at APA ethics, etc, I think you will find that they reflect a kind of care that is absent in what you describe, but is the standard for accredidation. That's not to say it's implemented everywhere, but as I said before and as I see it- there's no reason it should not be. I would be careful confusing the issue- at the core their is a standard and mistreatement is not sanctioned- even if it happens. The ethical treatment of youth is something that should be secured- period. Because it's not by accrediting bodies does not mean that the mistreatment itself is acceptable. "
Yeah, and if you look at the printed rules and espoused dogma of any of the Seed spin offs, it's the same. In print, they have nothing but the highest regard for the youth in their care. Hell, they all started out on front row themselves. But that breaks w/ the reality on the ground (or in the group room, as it were)
Even now, if you're a bit nebish, you can look in on the ongoing argument between me and my brother over The Seed. That's been going on for at least 20 years. He still insists that the Seed was all about love and honesty and honor and all that. He does concede that Straight may have been worse, but only cause he wasn't there to wittness the same tired and weak dogma coming out of the mouths of Seedlings who staffed Straight as he'd heard over on Ft. Lauderdale.
Doesn't matter how abusive the actual day to day treatment of the captives, so long as they can make it look good on paper.
No, I don't have any faith left in regulation, legislation or litigation to make this situation any better, EXCEPT one thing. That thing is that regulation, legislation and litigation are the national passtime. If you want people to think about an issue and respond as they see fit, those are the next best ways to make that happen after direct appeal to the IVth Estate. That's what I'm banking on; the media, all of it, from satire to legally defensible documentary. Education (rampant talking out in group) is the key, I'm convinced of it.
Why should we take advice on sex from the Pope? If he knows anything about it, he shouldn't.
--George Bernard Shaw, Irish-born English playwright
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A prime example of Ginger's thoughts, concerns, worries is what just happened recently in Ohio:
Three valid complaints were just recently denied by ODADAS regarding complaints against their very "lovely" pet mind experiment called Kids Helping Kids.
This program is regulated and certified by the state of Ohio....what a joke considering that they are using the exact same thought reform tactics at KHK that they used at Straight Inc./Seed.
warm regards,
-DPI don't believe in God. My god is patriotism. Teach a man to be a good citizen and you have solved the problem of life.
--Andrew Carnegie, Scottish-born American industrialist and philanthropist
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QUOTE: Instead of preventing abuse, we're codifying the proper, legal way to do it effectively w/o leaving overt forensic evidence. ////
Ginger has valid points. Kat sounds frustrated because she is coming to realize that this is not going to go away over night and that the process is going to be long and tough. And, that maybe there are things that need to be looked at that might not have been considered.
Yes, like Kat others of us agreed that licensing, regulation, and litigation were the answer. But it's becoming abundantly clear that those things are not the answer to this massive problem. We have to begin to dig deeper. It's not to say that these things are not a good start in that they may cause media attention and get the word out there about the abuse. But in the big scheme of things, as pointed out, this has been going on for some 30 years and what have we seen? We need to be honest with ourselves and agree that what we are seeing is growth - growth of the industry, and that they are keen and clever. Take NATSAP, that in and of itself is scary. People fall for the fact that NATSAP regulates programs when in reality they are regulating themselves. They are program operators who are on the board. Just like the new board in Montana where 3 on the board are program folks and 2 are from the general public. Not fair, in my book. That's not usually effective, now is it. Typically there would be outside agencies monitoring and regulating an industry such as this. But in this case it just doesn't work that way.
We have a long way to go so we'd better all hunker down and figure out how we can help in a truly meaningful way.
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"We need to be honest with ourselves and agree that what we are seeing is growth - growth of the industry, and that they are keen and clever. Take NATSAP, that in and of itself is scary. People fall for the fact that NATSAP regulates programs when in reality they are regulating themselves. They are program operators who are on the board. Just like the new board in Montana where 3 on the board are program folks and 2 are from the general public. Not fair, in my book. That's not usually effective, now is it. Typically there would be outside agencies monitoring and regulating an industry such as this. But in this case it just doesn't work that way. "
A few points you might consider: NATSAP does not self-regulate. It doesn't regulate at all. You send them a check, sign a paper saying you agree with their ethics and principles, and then don the holy mantle of NATSAP purity.
The difference in the Montana board is that they ARE monitored by an outside agency---the department of labor and industry's health care licensing bureau. Your assumption that this sort of self-regulation (really a mis-nomer) doesn't work needs support and documentation, because in Montana, it works very well. There are about 40 state boards that regulate many different professions, and there's a nice climate of teamwork rather than an adversarial relationship (which is truly the kind that never accomplishes much).
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I agree that there should be one law, one very strong law, that would protect the children in any residential program. One FEDERAL law for all states. Individual state laws is frightening and there is way too much room for error.
Here are some things I found on natsap.org website:
NATSAP'S INTERVENTIONS, ETC.: http://www.natsap.org/BehaviorMgtPrinc.pdf (http://www.natsap.org/BehaviorMgtPrinc.pdf) (any NATSAP member may resort to physical restraint ... "Mechanical restraint: a procedure where a mechanical device such as leather belts, posy belts, straight jacket, hand cuffs, and other devices are used to restrict the movement of an individual. Therapeutic holds (see 4.4) that are longer than 30 minutes in duration, are also considered restraint procedures." Check out 4.4, it tells you that the child can receive mechanical restraints for such things as punching a wall, scratching or carving in an attempt to cause damage, etc. - wonder what "etc." can be construed to mean. Also, slapping, kicking ... damaging furniture ...) I don't know about any of you who have had their own teenagers, or who have been around teenagers, but it is not unusual to walk into a home where teenagers live to find a hole in a wall. I've seen it many times in the homes of friends who have normal families. Kids get angry sometimes, kids hit walls sometimes, kids make holes in walls sometimes. I don't think the punishment should include the words "leather belts, posy belts, straight jacket, hand cuffs..." - I don't know, am I too permissive? What? Or do others here find that normal kids and normal folks sometimes get angry, sometimes hit a wall, sometimes damage furniture, yet they don't end up in a straight jacket, do they?
NATSAP'S SUPPLEMENTAL PRINCIPLES: http://www.natsap.org/Supplemental%20Pr ... 202004.pdf (http://www.natsap.org/Supplemental%20Principles%2006%202004.pdf)
NATSAP'S PRINCIPLES:
The following principles of good practice have been unanimously adopted by the board of directors and membership of the National Association of Therapeutic Schools and Programs as basic principles of practice ascribed to by member programs and schools. Full members certify compliance with the practice principles while associate members aspire to these principles, but are not yet in full compliance. The intent of this statement of practice principles is to raise the general level of operating practice within therapeutic programs and schools.
These guidelines refer to therapeutic programs and emotional growth schools as ?program/schools? and refer to client/students as ?program participants?.
1.0 ADHERENCE TO STATE AND FEDERAL LAWS
The program/school shall adhere to all applicable state and federal laws in conducting the operation, including administration, hiring and employee practices, observance of safety regulations, and the care of program participants.
2.0 ADMINISTRATIVE PRACTICES AND PROCEDURES
The program/school has a responsibility and duty to strive to provide its program participants with appropriate ethical and professional service in all areas of operations.
2.1 The program/school will have a written plan for governance, program administration, and professional services. The Plan includes the following elements.
2.1.1 Introduction and history of the program/school.
2.1.2 A delineation of the responsibility of the governing body including, policy development, responsibility for implementation, compliance, amendment, and oversight of the policies.
2.1.3 Mission Statement.
2.1.4 Philosophy of the program/school.
2.1.5 Description of the population the program/school serves, including admission, non-admission and discharge criteria.
2.1.6 Description of services provided.
2.1.7 Organizational Structure including an organizational chart.
2.1.8 Tuition / Fee statement including all ancillary cost, and refund policy.
2.1.9 A plan for self-evaluation and program/school improvement.
2.2 The program/school shall have proof of general liability, professional liability, fire, and vehicle insurance coverage as appropriate.
2.3 The program/school will follow accepted accounting practices.
2.4 Member schools/programs will:
2.4.1 Not offer or accept payment for referrals.
2.4.2 Represent facts truthfully to program participants and third-party payers.
2.4.3 Disclose fully all costs and fees for service.
2.4.4 Respect copyrights, trade authorship, and proprietary information, and will not plagiarize or use materials, documents, or resources from other sources or programs without permission.
2.4.5 Not use a name or marketing strategy that misleads the public or makes guarantees of outcome to consumers.
2.4.6 Disclose fully all ownership and financial relationships between associated programs, services, and professionals where there is a potential for a conflict of interest.
3.0 EMPLOYEE PRACTICES
The program/school will only provide services (including assessment services), that lie within the scope of the service, training and qualifications of its staff. The program/school will accurately and factually represent the competence, education, training, certification and experience of its employees. NATSAP members will not discriminate on the basis of race, religion, gender, or sexual orientation.
3.1 Hiring Practices
3.1.1 Applicants are required to complete an Application for Employment. The application form must include the following.
3.1.1.1 Previous place(s) of employment.
3.1.1.2 Signature, verifying that all information is correct and factual.
3.1.2 Upon extending an offer for employment, the program/school will obtain:
3.1.2.1 A criminal background check including driving history.
3.1.2.2 A minimum of two professional references (written or verbal).
3.1.2.3 Proof of professional credentials.
3.1.2.4 A medical examination or statement signed by the employee assuring fitness to execute the physical and mental requirements delineated in the job description.
3.1.2.5 If the employee is required to drive a company vehicle, or is asked to transport program participants in his/her own car, the Department of Motor Vehicle will be contacted to determine that the respective employee has a valid driver license.
3.2 On-Going Employee Practices
3.2.1 Each employee will have a written job description. The job description will include the following:
3.2.1.1 Job title.
3.2.1.2 Duties and responsibilities.
3.2.1.3 Minimum level of education, training and work experience required for the position.
3.2.1.4 Physical demands of the position.
3.2.1.5 Lines of authority. (Delineation of supervisory responsibility)
3.2.2 The program/school shall have written Employee Policies and Procedures that will include policies on:
3.2.2.1 New Employee orientation procedures including:
3.2.2.1.1 Orientation in philosophy, objectives and services.
3.2.2.1.2 Emergency procedures. (Fire, Disaster, etc.).
3.2.2.1.3 Current program/school policy and procedures including behavior management.
3.2.2.1.4 First aid and CPR training.
3.2.2.1.5 Statutory responsibilities, including those covered by state and federal laws.
3.2.2.2 Continuing staff training and development.
3.2.2.3 Performance appraisals.
3.2.2.4 Methods for filing and addressing employee grievances.
3.2.2.5 Disciplinary actions, termination, and discharge practices.
3.2.2.6 Sexual and other forms of harassment or misconduct.
3.2.2.7 Abuse reporting laws
3.2.2.8 Vacations, holidays, illness, extended leave, military leave, and jury duty.
3.2.2.9 Volunteers, interns, and contract personnel if applicable.
3.2.2.10 Confidentiality and information disclosure within the limits recognized by appropriate professional standards, including state and federal regulation.
3.2.2.11 Transporting program participants and their parents/guardians.
3.2.2.12 Prevention and investigation of allegations levied by program participants regarding employee misconduct.
3.3 Personnel File
3.3.1 The program/school will maintain a personnel file on each employee that includes:
3.3.1.1 Application and/or resume
3.3.1.2 Background clearance.
3.3.1.3 Proof of credentials including education, licensure, certifications, etc. as applicable.
3.3.1.4 Proof of medical examination or statement of ability to perform duties.
3.3.1.5 Signed job description.
3.3.1.6 Documentation of new employee orientation and ongoing staff development training.
3.3.1.7 Performance evaluation(s).
3.3.1.8 Emergency contact information.
3.3.1.9 Documentation of disciplinary actions, termination or discharge.
3.3.1.10 Signed confidentiality agreement regarding the exchange of information concerning program participants, their families, and fellow workers.
3.3.1.11 Copy of driver?s license (if employee is required to drive a company vehicle as part of the job).
3.3.1.12 Documentation of employment status e.g., hourly, salary, part-time, full time, exempt, non-exempt, etc.
4.0 ADMISSION/DISCHARGE POLICY
The program/school will have a written Admission Policy, which defines the enrollment criteria and delineates inclusion and exclusion criteria. Such criteria will be consistent with the mission of the program/school. Admission forms will provide pertinent history including family, medical, psychiatric, developmental, and educational background information.
4.1 The Admissions screening process will examine the physical, emotional, behavioral, and academic history, in order to determine whether the program is appropriate in light of the prospective participant?s needs and limitations
4.2 The program/school will provide program participants, parents, legal guardians, or other pertinent parties with a clear and informed statement of the nature of the services that will be provided including, risks associated with these services.
4.3 Upon admission, a file will be created for each program participant, containing the following:
4.3.1 Demographic information including emergency contact information.
4.3.2 Basic medical, family, behavioral, legal, educational, information including past and current assessments.
4.3.3 A signed statement indicating receipt of a copy of the student handbook or statement of Participants Rights and Responsibilities, or a witness attesting to the participant?s refusal to sign.
4.3.4 Contract, release and consent forms.
4.3.5 Documentation of communication with parents, legal guardians, payer sources and other parties.
4.3.6 Photograph.
4.3.7 Copy of any grievance filings and action taken.
4.3.8 Documentation of services rendered.
4.3.9 Discharge summary and academic transcripts
4.4 The program/school will conduct on going assessment to determine appropriateness of continued placement.
4.5 Upon termination or discharge of a program participant, the program/school will make appropriate recommendations for continuing care and/or education.
5.0 BEHAVIOR MANAGEMENT PLAN
5.1 The program/school shall have a written Behavior Management Plan which describes:
5.1.1 How human dignity and rights will be respected in the application of behavior management practices.
5.1.2 Special treatment / intervention processes including such techniques as: seclusion, restraint, therapeutic holding, passive holding.
5.1.3 Procedures for handling emergency situations such as suicidality, abuse, assault, and runaway.
5.1.4 Acceptable and non-acceptable consequences.
5.1.5 On going training procedures for employees.
6.0 PARTICIPANT RIGHTS AND RESPONSIBILITIES
6.1 The program/school will have a written Student Handbook or statement of Program Participant Rights and Responsibilities as appropriate to the setting, purposes, and pertinent state and federal law. Such manual or statement will include statements regarding the following rights:
6.1.1 To receive care or services within the program?s capability, mission, and applicable law and regulations.
6.1.2 Freedom from discrimination.
6.1.3 The expectation of a safe environment with respect of human dignity.
6.1.4 Respect for privacy of information and records of each individual and family served.
6.1.5 A description of any restrictions in communication or visitation.
6.1.6 A description of privileges and limitations for participants.
6.1.7 A description of access to religious services and practices.
6.1.8 A statement indicating that the program/school retains the right to maintain a contraband free environment and a description of any search or testing procedures used in this effort.
6.1.9 Procedures for student/participant grievance and complaint will be clearly outlined along with a statement guaranteeing freedom from retaliation for making complaints.
6.1.10 A diet that is nutritionally sufficient for age and activity level.
7.0 HEALTH CARE ACCESS
7.1 The program/school will have a policy on health care that addresses the following issues:
7.1.1 Access to appropriate medical care.
7.1.2 Delineation of whom is authorized to dispense medications.
7.1.3 A policy on storing, accounting, and security of medication.
8.0 SAFETY
8.1 The program/school shall have Plant, Technology and Safety Policies and Procedures containing the following:
8.1.1 A fire and disaster plan which includes the following:
8.1.2 Delineating responsibility of all employees in the event of fire or other disasters
8.1.3 A description of available emergency services, escape routes, relocation plans, and other contingency plans.
8.1.4 Documentation of all fire and emergency drills.
8.1.5 Policies concerning staff training for emergencies and access to emergency medical care.
8.1.6 A safety committee who will be responsible for risk management as well as training and implementation of emergent procedures.
8.2 A policy or procedure for equipment maintenance and repair
8.3 An Infectious Disease Control policy
9.0 INCIDENT REPORTING
9.1 The program/school will have an Incident Reporting policy and procedures, including a reporting mechanism to the governing body.
NATSAP - MISSION
The National Association of Therapeutic Schools and Programs serves as an advocate and resource for innovative organizations which devote themselves to society?s need for the effective care and education of struggling young people and their families
The National Association of Therapeutic Schools and Programs (NATSAP) was created in January of 1999 to serve as a national resource for programs and professionals assisting young people beleaguered by emotional and behavioral difficulties. NATSAP publishes a directory annually to inform professionals, programs, and families about the many residential placement alternatives available to help struggling young people.
Listed alphabetically, the schools and programs in the Program Directory are diverse. From boarding schools and residential treatment centers to wilderness programs and group homes, the directory's listings offer a wide range of programmatic types, lengths of stay, and services to meet the needs of a variety of troubled young people. The upper section in each listing provides the reader with pertinent contact and program information, while the paragraph section is split into three parts describing operational philosophy, candidate and population specifics, and an overview of how services are provided.
Matching the services of a particular school or program to the specific needs of a young person is arguably the most important decision that will ever be made on behalf of that young person. The NATSAP directory serves well as a quick reference guide. While it is not intended by itself to supply enough information to make a placement, it can help start the process. NATSAP encourages programs, professionals, and families to have appropriate academic and psychological testing conducted and to use multiple informational resources before suggesting or pursuing a placement for any young person in any program.
Each young person has his or her own specific needs that must be determined in detail before placement in any program is appropriate. Since NATSAP has no means of determining the needs of young people whose counselors or families may be using this directory, we do not recommend specific programs.
The National Association of Therapeutic Schools and Programs is not an accrediting or licensing body at this time. We are a volunteer membership organization supporting professionals and programs in their efforts to help troubled young people. Gaining full membership in NATSAP is a multiyear process.
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"A sweet 34,000 campaign, and the whole concept of regulation is cast by the wayside."
Not that it was cast by the wayside; it was moved to the right department. But come on, TSW. What do you suppose the health department spent on their lobbying campaign? And they don't even have to report it as such. Why are they so adamant? Could it be relevant that, according to their own internal memo and testimony in the legislative hearings, just starting a study would cost over a quarter million a year?
For them, it's all bucks, and so is most of the regulatory business. As pointed out already, it guarantees absolutely nothing. There have been far more deaths and scandals per capita in state-run licensed programs than in private, non-licensed.
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On 2005-10-31 16:05:00, Anonymous wrote:
For them, it's all bucks, and so is most of the regulatory business. As pointed out already, it guarantees absolutely nothing. There have been far more deaths and scandals per capita in state-run licensed programs than in private, non-licensed.
Ok, that is a little misleading. There are more kids in state run and licensed programs, and most of them haven't got wealthy parents.
Never the less, TSW, I think you're missing my point. I just described to you a few of the stressors I experience as a newcomer at Straight (which was licensed, and so are the still operating spin offs). Now, you can regulate away things like locks on the doors, but how do you regulate away another inmate who's willing to sleep in front of the door to prevent escape? You can regulate mandatory access to phones, but how do you regulate away the subtler forms of retribution.
Hey, technically? Any kid who was not court ordered in Straight has always had the legal right to leave. They just wouldn't be allowed to and, if they asked, they'd get yelled at, started over, loss of 'priviledges' like a balanced diet.
How would you write the law that would effectively protect kids in treatment from a million little annoyances and stressors that, all together, amount to a dangerous level of harassment?
I don't think there can ever be such a law. I don't think law enforcement is the right tool to use here. You think individual state regulation is frightening? I think this issue falls into the province of individuals, families and communities. Happy Haloween! lol
Seriously, On 2005-10-31 08:18:00, Three Springs Waygookin wrote:
The real problem is money. This sick industry just makes to damn much money. It might be better off handing out printing presses to let these programs run off their own gelt. With this money comes power, and with power comes influence. I wonder just how many politicians the pain and suffering of children has bought in this country?
Well, what do you think will happen when there's a Federal government office with a shiny new budget in charge? Remember that at least 3 former Straight staff went on to hold the cabinet level posision of Drug Czar. You think Alberto Gonzalez is going to vigerously investigate and prosecute complaints about intense group interrogation? In fact, you can't trust a damned thing the Federal Government does wrt drug treatment. These crazy bastards are actually fighting hard to keep up the Federal prohibition on medical marijuana in all the states that have legalized it. They actually held a crippled woman at gun point and demanded that she get up and walk out of her hospital bed. You think these people are going to see to the dignified, safe and proper treatment of pot smoking teenagers?
I think we, as a culture, need to have a better understanding of the problem so the current and next generation of us will not tolerate, far less pay for, this kind of 'treatment'. We take an hysterical position on so many intertwined issues here. For instance, that all illicit drug use is, not just not to be desired, but so horribly bad and dangerous as to justify any response, no matter who dies, never mind whether it makes a damned bit of sense or not.
That's a myth. That's a BIG one among them and Americans need to grow the fuck up about it.
May your days be joyfully challenging and your words artfully true
-- Ginger Warbis SMA, `00
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****Kids get angry sometimes, kids hit walls sometimes, kids make holes in walls sometimes. I don't think the punishment should include the words "leather belts, posy belts, straight jacket, hand cuffs..." - I don't know, am I too permissive? What?
Of course not.
If the intention is to 'teach' anything, the teen should learn that punching a hole in a wall will cost them some time and money. Purchasing the materials to repair the hole and acutally repairing it. It's not difficult these days, provided the hole is not huge. All the materials are available at the local WalMart or hardware.
What does a mechanical restraint, or any restraint for that matter, teach? A consequence that is totally unrelated to the incident.
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More than that, why is the kid that frustrated? What problem are they unable to resolve? In too many cases, I think it's that they get fed up to the eyebrows w/ disrespectful, undignified treatment by alleged adults.
Sometimes, punching a wall is just about the sanest, healthiest thing anybody ever did. [Religion is] the daughter of hope and fear, explaining to ignorance the nature of the unknowable.
--Ambrose Bierce
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Oh, two other things. Thanks for all the kind words, you guys. Means a lot to me.
And a sumation. I'm basically with Will Rogers on this; giving money and power to government is like giving whiskey and car keys to teenaged boys. Giving the Fed and local governmnets even more money and power would be counterproductive. We should take it away, keep it, spend it as we see fit in the communities where we live. That would help all by itself.
But, in the mean time while the 50 Billion Dollar Gravy Train has been rolling, we've gotten an infestation of a particularly onorous variety of vermin established in all levels of community and government. We desperately need to expose these people for who and what they are and count on our good neighbors to help us throw the bums out so they can quit voting themselves raises!
In the 60's people took acid to make the world weird. Now the world is weird and people take Prozac to make it normal.
--Unknown
_________________
Drug war POW
Straight, Sarasota
`80 - `82
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Happy Halloween!! LOL
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On 2005-10-31 21:16:00, Anonymous wrote:
"Happy Halloween!! LOL"
:wave: I am not a vegetarian because I love animals; I am a vegetarian because I hate plants.
-- A. Whitney Brown
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I feel everyone's frustration over the regulation issue - frankly, it could be quite sometime before HR 1738 even gets on its committee calendar for hearings, because Rep. Boehner (OH), the Education committee chair who sets the agenda, apparently has some ties to Kids Helping Kids. I'm speculating on that one, of course, but I think it's fair to say that many of us feel a little cynical at times.
I agree wholeheartedly that passing a few regulations won't solve the abuse. Miller's bill proposes $50 mil. to set up regulatory agencies/panels in each state - $50 mil. is a drop in the bucket, but it's a start. I do support the bill, however, not because I think it will just "fix" everything - but if nothing else, it will get some public dialogue going. And of course, the more public we all can make it, the better.
I was at Cross Creek Manor (WWASP) for 18 months several years ago, and my "therapist" was a lisensed social worker (not typical for WWASP programs). I can tell you first hand, that "professionals" can be very dangerous if they do not act ethically - which Garth certainly did not.
I guess you could say that they really know how to mindfuck you in the most efficient way possible...
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Kelly, I'm sorry you were harmed at a program. They most definitely are great at the mindfuck game.
I'm conflicted about this whole regulation thing as well. At first, I was totally for it thinking that it was going to be a great start. Then, I stopped and thought about what they were truly proposing, as well as the fact that the thing isn't even up for hearing yet because Boehner hasn't scheduled it, then I got a bit bummed out about the whole thing.
First of all, I guess I always knew it wasn't the answer, the whole answer. But I did have great hopes that it would help. I'm with you guys in that if it can get public attention, then fine, go for it so long as there's nothing that will, in the long run, harm the kids further. One thing this industry truly needs is EXPOSURE!!!!!!!!!!
You know, this is sickening when you think about it. Kids are being fucked. Parents are paying for it. I do believe that most parents are ignorant to what is going on, I'm sure some are not and buy into the whole "tough love" shit. But I think that many parents, if they really knew what they were signing their kids up for, would think again before signing on the dotted line. I've reviewed some of the program's Enrollment Agreements and it's unreal what parents agree to. Un-fucking believable, really. Most people wouldn't sign their pets up for something like that, yet it's OK for their kid?
Here's an example of just one of the program's Enrollment Agreements: http://www.intrepidnetreporters.com/Tee ... #Restraint (http://www.intrepidnetreporters.com/TeenHelp/contract.htm#Restraint)
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I've read that contract (Paradise Cove) - since all of that stuff was posted on intrepidnet around 1999, I think that my contract may have looked something like that, but I'm not sure...
I it's a little reactionary to write off everything that the Fed. government does/has done. Is there a lot of ridiculousness that gets funded through tax revenues, like $50 bil. bridges in Alaska? Absolutely. But there are a lot of people in this country who depend on public assistance - Medicaid, CHIP (children's health insurance), Section 8 housing, Food Stamps... and, contrary to popular belief, these people are not "living on the dole" and frankly, all of those programs, as are many others, are ridiculously underfunded... But the private sector could do a better job, right? Wrong. Come to Texas, where Dubya, when he was Governor in the 90's, privatized virtually all of our state's social services - when it comes to stats involving health insurance, wage gaps, assistance for those living in poverty - Texas is consistently fighting with Mississippi & Louisiana over the bottom (out of 50) spots. Basically, if you're poor, you probably don't want to live in Texas...
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Kelly, here's the thing. What happened w/ welfare in Texas is not an example of the failure of the welfare state. It's par for the course. Ask anyone who's immigrated here from a Socialist country (no shortage of them, either).
And, as you note, nothing is going to happen anytime soon if Ohio has anything to do with it. You want to know how tight the Taft office is w/ the Straight line of programs? (i.e. the particular franchise that's been tight w/ the Whitehouse all the way back to the Nixon admin) Check out Dan Forbes 2002 investigative report, The Governor's Sub-rosa Plot to Subvert an Election in Ohio. In the 45 page pdf linked from the yellow box to the right of the main text, see pages 13, 27, 29, 30, 31 and 34 for specific mention of DFAF staff by name.
If you're poor (or even not quite well off) you don't want to live in Pennsylvania or Florida, either. I don't think public welfare is a bad idea because it helps poor people. I think it's a bad idea because it keeps them down. I'm old enough to remember a time when one man working a full time job w/ a little side work could support a wife and 6 kids fairly well. Ok, so we didn't have all the latest and greatest toys and fashions and such. But we had NO idea we were poor or anything. As amazing at it may seem today, most people carried catastrophic health insurance (hospitalization) and life insurance. But we paid about $10/head for doctor visits. That was before the advent of HMOs. That was before the well intended do gooders inside the Beltway mandated by law that every employer must take some of our pay and give it to the HMOs or restrict us all to under 30 hrs per week.
All good intentions aside, they fucked us!
So now we have a contrived shortage in healthcare. There's not really a shortage of talent, people willing to serve, medications or equipment. It's just so tightly regulated that no one can afford it.
All good intentions aside, the regulators have damaged America's medical services profoundly.
When you talk about privitizing social services a la Büsh, you probably don't know it but what you're talking about is, verbatim, a Social Democratic plan right out of Mein Kampf. We're still paying (and the rates just went up) and everyone involved (except those who invest prudently in public policy) are still bound by all of the rules and regs. But it's not anything even close to a free market. It's the opposite. It's a fascist arrangement where private business is given public funding and the full authority of law w/o the accountability we place on the public sector or the competition that would exist if we actually had a free market.
These Neocons, the Jacobians are all about removing regulations that limit the power of the corporations to whom they provide monopoly status. But they're not eliminating the taxes we all pay (even if you rent, who tf do you think is footing the tax bill?) and they never get around to eliminating the regulations that keep the rest of us frozen out of all important markets.
No, I'm still w/ Will Rogers on this one. Giving money and power to government is like giving whiskey and car keys to teenaged boys.
Are we at last brought to such humiliating and debasing degradation, that we cannot be trusted with arms for our defense? ... If our defense be the real object of having those arms, in whose hands can they be trusted with more propriety, or equal safety to us, as in our own hands?
-- Patrick Henry
_________________
Drug war POW
Straight, Sarasota
`80 - `82
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Ginger, no one in the federal government ever mandated employer-provided health insurance in the U.S.-- this is why there are still so many employers that don't provide it.
Employer-provided benefits were fought for by unions *because we refused* to make the government provide it. And HMO's came in when *companies* sought to save money on it and did so by hiring corporate bureaucrats to "cut waste" and when they ran out of waste to cut, we were left with another expensive layer of bureaucrats to pay for and so they didn't save the money as promised.
HMOS also didn't put the promised money into preventive health care, which would have saved money, because they realized that people switch jobs and so often that if you pay for prevention, you're saving *some other* employer/insurer money, so why bother?
"Socialist" countries like Canada and Britain provide quality health care for their entire populations and have lower infant mortality and higher life expectancy than we do. They also have many people on welfare and much less violence than we do and poverty there is far less extreme-- but the UK economy is booming and has been for last 10 years at least.
Health care is one of the few things that government does better than industry-- and this is so because health care cannot be a true free market for both ethical and practical reasons which are too boring and complex to get into here.
Regarding program regulations, Straight was never properly regulated. It should have been regulated as an inpatient program and should have been regulated as a psychiatric hospital since it used restraint and isolation. By using "host homes," it managed to avoid the regulations it should have been subject to.
While psychiatric hospitals do fall into scandals over isolation and restraint every now and then, there are much stricter regulations on them and institutional protections like complaint hotlines and patient ombudsmen that genuinely do reduce abuse when properly and consistently implemented.
The rules on the use of restraint and isolation in psychiatric hospitals are not the lip service that Straight made up to please the government-- they are implemented because the treatment philosophy is that patients should have dignity and respect, not because they need to pretend that to avoid lawsuits. Psychiatry has a lot of problems-- but one of them is not that it genuinely believes as a working philosophy that people should be shamed and humiliated to help them. Eliminating that assumption in itself prevents a lot of abuse-- though not all, because power corrupts.
However, there are also much tighter legal constraints, due to the recognition of this by the field and because of the work of advocates. For example, you cannot keep an adult locked up without appeal if they haven't committed a crime or don't have a diagnosis that means that they are a *current* danger to themselves or others.
That status needs to be determined by a judge in court and must be re-evaluated on a regular basis. Since inpatient psychiatric care is so expensive (and since these legal measures are so expensive), there are natural limits on overuse that simply aren't there with these programs.
This is why I believe regulation could make a huge difference, if done right.
What's needed is for teens to have the rights that adults do in terms of not being locked up unless they are convicted of a crime and given a determinate sentence or diagnosed with a condition that makes them a danger to self or others that demonstrably cannot be treated in less restrictive setting. And this must be determined by a judge and re-evaluated on an ongoing basis. And 24 hour access to a hotline for abuse complaints that sparks outside investigation.
This would take away 90% of the kids in these programs because they don't meet criteria for being untreatable in a less restrictive setting-- some don't meet criteria for needing anything at all. The other 10% need psychiatric care.
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***This would take away 90% of the kids in these programs because they don't meet criteria for being untreatable in a less restrictive setting-- some don't meet criteria for needing anything at all. The other 10% need psychiatric care.
That would be wonderful, but, how?
The federal ICPC, which is already in place but ignored by industry, parents, and state agencies; would do precisely that. If states only enforced it and followed the letter of the law.
Even if states were required to track down all the kids who are currently placed out of state, each state would simply file the appropriate paperwork and it would be business as usual, because when it's all said and done, no one at the state level really cares about the issue. Parents will whine that they've 'done everything' and there is no other alternative. No one at the state will investigate to determine if there is indeed a less restrictive option closer to home.
I truly hope it will bring some positive change, but won't hold my breath.
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Yeah, that's all great, if it were really true. I don't know the specific statutes and/or regulations to cite. It is not legal for most employers (w/ more than 10 or 30 or some other arbitrarily chosen number of employees) to employ a person full time w/o giving them insurance. I remember when that changed in So. Florida and it sucked BIG time! I was a young single mother, just barely making it week to week when they cut all of our hours from 40 to 30. That's the loophole, ya know. Anyone working under 30 hrs per week is considered 'part time' and not entitled to insurance. So most of us had to go out and get TWO part time jobs to keep our heads above water.
On 2005-11-07 19:45:00, Anonymous wrote:
What's needed is for teens to have the rights that adults do in terms of not being locked up unless they are convicted of a crime and given a determinate sentence or diagnosed with a condition that makes them a danger to self or others that demonstrably cannot be treated in less restrictive setting. And this must be determined by a judge and re-evaluated on an ongoing basis. And 24 hour access to a hotline for abuse complaints that sparks outside investigation.
This would take away 90% of the kids in these programs because they don't meet criteria for being untreatable in a less restrictive setting-- some don't meet criteria for needing anything at all. The other 10% need psychiatric care.
You are absolutely trippin' your brains out here! Just look into the history, PLEASE!
As far back as the early `80's, Fred Collins brought much attention and a bevy of regulators to Straight, Virginia for the very reason that they held him against his will. And he won, too, big time to the tune of over $700k. That worked out well for him, he put himself through school and has lived happily ever after. But did it actually change the way Straight did business? Fuck no! Ask anybody who was there or just read what so many have already taken the time and trouble to write. For brief periods, they banned 'motivating'. Not that it was anywhere near the most harmful practice in that place, but it was just too weird to explain, I guess. And they banned locked windows and doors, replacing them w/ motion detectors and human beings made to sleep in front of the doors and windows.
Straight, Inc. was extremely regulated. So have been the psyche wards of the bad old daze.
I remain of the opinion that we've had just about all the help we can stand. Please quit helping so much.
He, who has nothing, and who himself belongs to another, must be defended by him, whose property he is, and needs no arms. But he, who thinks he is his own master, and has what he can call his own, ought to have arms to defend himself, and what he possesses; else he lives precariously, and at discretion.
James Burgh 1774
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Hey Ginger,
Apologies for not replying sooner- things have been crazy busy for me. Hearing your story and those of many people, esp. recently coming out of regulated and licensed institutions I can only say this- my hope is that we can garner enough support for improvements in local care so that youth who are struggling an their families have options, and that residential care is only limited to those who need it, who are truly in dire straits. A Start's work is focused on regulation strictly, but that's not what the Bazelon Center is only interested in, for instance, and for that I admire their work greatly. I love this factsheet posted on their site:
Fact Sheet: Children in Residential Treatment Centers
I. Tens of thousands of children with mental health needs are being placed in expensive, inappropriate and often dangerous institutions.
The number of children placed in residential treatment centers (or RTCs)[1] is growing exponentially.[2] These modern-day orphanages now house more than 50,000 children nationwide.[3] Children are packed off to RTCs, often sent by officials they have never met, who have probably never spoken to their parents, teachers or social workers.[4] Once placed, these kids may have no meaningful contact with their families or friends for up to two years.[5] And, despite many documented cases of neglect and physical and sexual abuse, monitoring is inadequate to ensure that children are safe, healthy and receiving proper services in RTCs.[6] By funneling children with mental illnesses into the RTC system, states fail?at enormous cost?to provide more effective community-based mental health services.[7]
A. RTC placements are often inappropriate.
RTCs are among the most restrictive mental health services and, as such, should be reserved for children whose dangerous behavior cannot be controlled except in a secure setting.[8] Too often, however, child-serving bureaucracies hastily place children in RTCs because they have not made more appropriate community-based services available.[9] Parents who are desperate to meet their kids? needs often turn to RTCs because they lack viable alternatives.[10]
To make placement decisions, families in crisis and overburdened social workers rely on the institutions? glossy flyers and professional websites with testimonials of saved children.[11] But all RTCs are not alike.[12] Local, state and national exposés and litigation ?regarding the quality of care in residential treatment centers have shown that some programs promise high-quality treatment but deliver low-quality custodial care.?[13] As a result, parents and state officials play a dangerous game of Russian roulette as they decide where to place children, because little public information is available about the RTCs, which are under-regulated and under-supervised.
To make it worse, far too many children are placed at great distance from their homes. For example, most District of Columbia children in RTCs are placed outside the District?many as far away as Utah and Minnesota.[14] Many families, especially those with limited means, find it impossible to have any meaningful visitation with their children.
B. Evidence is limited on the effectiveness of RTCs.
Children frequently arrive at RTCs traumatized by the process that delivered them there. They are often forcibly removed from their homes in the middle of the night by ?escort companies.?[15] Other times, children are placed in RTCs not by their parents or doctors, but by overburdened child-serving state agencies, who know little about the children?s individual needs.[16]
Even more appalling, many children?s conditions do not improve at all while at the RTC.[17] In fact, there is little evidence that placing children in RTCs has any positive impact at all on their mental health state[18] and any gains made during a stay in an RTC quickly disappear upon discharge, creating a cycle where children return again and again to RTCs.[19]
There are many reasons why RTCs fail to deliver the results they promise, but most center on the type of services provided, the environment they are provided in and the lack of family involvement.
First, the reality of what occurs within an RTC is often quite different from the highly individualized, highly structured programs that are advertised. The RTCs often provide less intense services and the staff are often under-trained.[20] Children spend much of their day with staff who are not much more qualified than the average parent and they spend less time face-to-face with psychiatrists than they would if they were being served in appropriate community settings.[21]
The environment is also problematic because children in RTCs enter a situation where their only peers are other troubled children?a major risk factor for later behavioral problems.[22] Research has demonstrated that some children learn antisocial or bizarre behavior from intensive exposure to other disturbed children.[23]
Children are usually far from home in RTCs, often out-of-state.[24] Removed from their families and natural support systems, they are unable to draw upon the strengths of their communities and their communities are unable to contribute to their treatment. Few children thrive when they are hundreds or thousands of miles from their parents, friends, grandparents and teachers. Few can flourish without the guidance of consistent parenting. Yet, we expect that our most vulnerable and troubled youth will miraculously turn around in just such a situation. Instead, this isolation further reduces the efficacy of treatment and increases its cost.[25]
The fact that children and their families are far from one another creates a host of problems. For one, it makes family therapy difficult or impossible. As a result, when children leave the RTC, they return to an environment that has not changed. Also, because the RTC environment is inherently artificial?children are not asked to negotiate the obstacles that occur within their family setting or deal with the difficulties that trigger their behaviors in their neighborhoods or schools?the child does not gain new skills to better negotiate life outside of an institution. As a result, neither the children nor their parents learn better ways to overcome the obstacles that led to the RTC placement. Without family involvement, successes are limited.[26]
Among the rare children who are able to overcome these obstacles, few can sustain the gains they have made. In one study, nearly 50% of children were readmitted to an RTC, and 75% were either renstitutionalized or arrested.[27]
C. Children suffer because there is no watchdog.
The RTC industry is largely unregulated.[28] RTCs need only report major unusual incidents (or MUIs), but the interpretation of what constitutes an MUI and the reporting requirements vary widely.[29] Some RTCs fail to report MUIs at all?with little consequence.[30] Vulnerable kids are placed far from home where parents, social workers, or the state can offer little oversight or protection. Worse, many of the facilities limit children?s ability to have contact with their parents for extended periods, further restricting the parents? ability to monitor the facilities.[31]
D. Children are abused in RTCs.
Children placed in RTCs have been sexually and physically abused, restrained for hours, over-medicated and subject to militaristic punishments; some have died.[32] The following are just a few documented examples of tragic occurrences at RTCs:
Medication is often used (and overused) to control behavior.[33] Children have been permanently disfigured because of over-medication.[34]
In some programs, the children?s shoes are confiscated to keep them from running away.[35]
There have been reports of behavioral ?therapies? being misused. As one author noted, ?Such therapies do little more than systematically punish children, all under the guise of treatment . . . .?[36]
Sexual abuse by staff members and other residents is all too frequent.[37] In one case, a 13-year old girl performed sexual favors for staff members in return for snacks and carryout food.[38] At one RTC, four boys were accused of trying to sodomize another with a cucumber.[39] At another, a 19-year-old woman was charged with sodomizing a 14-year-old girl.[40]
Physical abuse is also too frequent an occurrence. For example, a 13-year-old boy was forced against a wall and slammed to the floor by employees of an RTC.[41]
Children are often restrained?sometimes for hours on end. The overuse of restraint has resulted in child deaths.[42]
E. Tragic outcomes at great public expense.
RTCs have grown to a billion-dollar, largely private industry.[43] Residential treatment care is exorbitantly expensive?costing up to $700 per child per day.[44] Annual costs can exceed $120,000.[45] Most of the time, the public foots the bill for these services.[46] In fact, nearly one fourth of the national outlay on child mental health is spent on care in these settings.[47]
II. Other Interventions Work Better for Less
Home- and community-based services are much more therapeutically effective than institutional services, and are also markedly more cost-efficient. As the Surgeon General reported, ?the most convincing evidence of effectiveness is for home-based services and therapeutic foster care? and not for RTCs.[48] A comprehensive system of care would dramatically reduce the number of children in RTCs.[49]
Community-based alternatives produce better short- and long-term results and are less disruptive to children and families. These alternatives provide intensive mental health treatment, mobilize community resources and help children and their families develop effective coping mechanisms. Some models endeavor to ?wrap services around? the child, while others emphasize multi-systemic therapy and crisis intervention. Randomized clinical trials found greater declines in delinquency and behavioral problems, greater increases in functioning, greater stability in housing placements and greater likelihood of permanent placement.[50] In Milwaukee, a wraparound project that has served over 700 youth involved in juvenile justice has shown similar promise; use of residential treatment has declined 60%, use of psychiatric hospitalization has declined 80%, and average overall care costs for target youth have dropped by one third.[51]
http://www.bazelon.org/issues/children/ ... s/rtcs.htm (http://www.bazelon.org/issues/children/factsheets/rtcs.htm)
Also, Bazelon is working with Federation of Families for Children's Mental Health who have been working to empower families with a promising approach to systems of care using the wrap around process. I haven't had the oppurtunity to read up on it much, but here are a few links on that. Ultimately though, the idea is kids are not sent away, but work closely with families and their community. I think it's safe to say we're all tired of youth being demonized and hearing about/experiencing these punitive methods using on kids in the name of therpapy. That's not therapy! Far as I can tell, the only way kids won't be sent away is if parents have local options that they are made aware of. And, of course, the public is made aware of the atrocities that go on and have gone on for many many many years. I just don't think most people know and would be appalled, particularly if more people were given a platform to speak out and share the damaging impact- my hope is that some of these organizations that are being made aware of these issues will take notice- finally. We need more people to share though, advocate for youth that are there now and who went through it themselves...We need movement, collaboration, joint effort. And, again, I can't stress enough just how grateful I am to have found this site. When strugglingteens.com stopped allowing honest discussion I just stopped talking. Then I found this site and its brilliant and so so important.
anyway- here are the links on systems of care and the warparound process. they're long- so if you have a moment, or many...
http://www.ffcmh.org/publication_pdfs/S ... VolOne.pdf (http://www.ffcmh.org/publication_pdfs/SystemsCareVolOne.pdf)
http://www.mentalhealth.samhsa.gov/medi ... ograph.pdf (http://www.mentalhealth.samhsa.gov/media/ken/pdf/2001Monographs/AIR_Monograph.pdf)
Ginger- what do you think??
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Well, Kat, this is really long and now I'm really busy. If I don't get back to it within a couple of days, please remind me.
Mean time, feel free to join the fun at
http://radioinsidescoop.com/mt-posts-ar ... 00506.html (http://radioinsidescoop.com/mt-posts-archive/000506.html)
Experience is that marvelous thing that enables you recognize a mistake when you make it again.
Mark Twain