These days, the term “residential treatment” describes a type of treatment where the adolescent actually lives at a treatment program facility for a period of time. Depending on the type of program, the teen may stay anywhere from a couple of weeks to 12 -18 months. The two types of out-of-home treatments that are used most, and often in tandem, are wilderness treatment programs and therapeutic boarding school programs.
A wilderness treatment program stay is typically between 8 and 12 weeks. While there is quite a variation in how wilderness programs are structured, what they all have in common is an outdoor/backpacking/nature emphasis. Teens spend anywhere from a couple of days at a time backpacking to preselected camp sites, to several weeks at a time without returning to basecamp.
In small groups of 4 – 8 teens, along with trained counselors with wilderness experience, they learn self-reliance skills as well as how to cooperate in a group setting. These programs incorporate self-esteem enhancing skills such as learning to set fires by hand, rock climbing, cooking, cleaning, and other challenges that push the teen safely past their preconceived physical limits. During the teen’s stay, they are regularly assessed by the clinical staff to determine if and when they might be ready to return home. The clinical staff then makes aftercare recommendations to the parents. If it is determined that their teen will return home, a return-to-home plan is developed to help the teen and parents continue to work in therapy to consolidate the gains made in treatment. If the clinical staff determines that the teen hasn’t made the psychological and behavioral changes necessary for success at home, a recommendation is made for the teen’s treatment to continue at a therapeutic boarding school program. It is estimated that between 50 and 80% of teens in wilderness treatment move on to therapeutic boarding school treatment.
The lengths of stay at therapeutic boarding schools are typically between 10 and 18 months. Therapeutic boarding school programs are not wilderness based although many have wilderness components. Teens live in dorm-like environments, attend school, participate in regular individual and group counseling as well as weekly family therapy phone/Skype sessions with their parents. Often the program recommends that the parents be in therapy while their teen is away to work on parenting issues that may have contributed to the teen’s problems while living at home.
The programs address substance abuse problems either as the primary reason the teen requires out-of-home treatment or a behavior stemming from psychological concerns such as depression, trauma, family dysfunction, etc. Call Mark Falls, Ph.D., a family, and addiction therapist in Santa Rosa at 707-525-9300 for an assessment.