In residential treatment centers, clients stay in the same facility where they receive treatment. Residential treatment typically takes place in a more home-like atmosphere compared to the more sterile atmosphere that occurs on inpatient, hospital-based units. This allows individuals to relax, socialize more, and develop schedules outside of their treatment programs.   

Issues to Consider When Contemplating Residential Treatment

Unfortunately, there is no formal standardized rating system or list that offers individuals contemplating residential treatment an easy resource to use to find an appropriate facility. Instead, individuals will have to search available facilities in their area within the parameters they are looking and attempt to find facilities that meet their needs. Using a checklist to rate each facility on the specific aspects of their program is the most efficient way to accomplish this task. 

According to information from the books Residential Treatment of Adolescents: Integrative Principles and Practices and A Guide to Treatments That Work, this checklist should include the following:

  • Determine if the program matches the client’s needs. No matter how well-maintained, luxurious, or professional a treatment center appears to be, the most important aspect of treatment is that it benefits the needs of the individual client. For instance, placing an individual in a residential treatment center that primarily deals with eating disorders when the individual has an alcohol use disorder is not the best course of action even if the treatment center has numerous attractive amenities or is more affordable than alternative centers. Residential treatment centers vary widely in their theoretical approach, the specific features of their treatment settings, goals, and living arrangements.

    In order for the treatment center to adequately serve the client, it should address the types of issues the person is presenting with, have programs of sufficient duration to deal with these issues and then move the individual on to the next level of care, offer the client a level of comfort so they do not feel overly stressed or that their privacy is constantly violated, meet the other specific needs of the client like any medical needs, and work with the client’s insurance program or budget.

    In addition, for individuals with involved family members, there should be visiting hours, and family members should be able to get to the facility without too much difficulty. Family support during treatment can contribute significantly to the successful outcome of the treatment.

  • Only consider treatment facilities that are accredited or licensed. The highest quality residential treatment centers allow themselves to be inspected and scrutinized by state licensing agents and other organizations that accredit healthcare facilities. These licensing and accreditation standards tend to be strict and cater to delivering the highest quality of care for clients (e.g., requiring the use of evidence-based treatment procedures). The standards are related to clients’ progress, the disbursement and storage of medications, and the credentials of treatment providers.

    Anyone looking to be placed, or place someone, in a residential treatment facility should immediately rule out facilities that do not have some form of accreditation or state licensure even if the program administrators attempt to explain away their reasons for not having any form of accreditation or licensure. For instance, the standards for these accreditations or licenses vary from state to state, and often, unaccredited programs cite this lack of consistency as a reason for not getting accreditations; however, this is not a reason for any facility to avoid being certified and accredited. The highest-quality programs are transparent regarding their procedures, credentials of their staff, documentation, etc.

  • The staff should be fully accredited and licensed. In conjunction with the facility having some form of accreditation or licensure, the staff members who work in residential facilities should also be licensed (in instances where licensure is appropriate, such as for physicians, therapists, and other treatment providers). Individuals who are licensed must meet certain educational standards, pass some form of qualifying examination, and have accreditation in their specific area of expertise.

    In some cases, staff members may be working toward licensure and may not have full licenses themselves. When this occurs, these individuals should be supervised by licensed professionals in their field.

  • Find out if the facility can increase its staff when the need arises. Many facilities do not work at full capacity, or there may be acute situations where some clients need more intensive supervision for a short period of time. It is important to make sure that the facility can meet the needs of a full caseload and can also recruit or bring in licensed staff who can assist the permanent staff when there are acute situations that require extra help.

  • The treatment facility should have immediate access to emergency care facilities. There is no such thing as facility that is accident-proof. Because clients in residential treatment centers often have numerous issues, there can be accidents or other issues that require emergency medical treatment. The facility should have 24-hour access to some emergency or urgent care facility in order to get clients immediate treatment when these situations arise.

  • The treatment philosophy should the needs of the client. This one may require a little bit of research. It is important to ensure that the treatment philosophy of the providers in the facility matches the needs of the client. For instance, individuals attending residential treatment for substance use disorders are most receptive to forms of Cognitive Behavioral Therapy. Treatment facilities that only have therapists that adhere to a psychodynamic or Freudian paradigm may be very adept at working with individuals who have past trauma but may not be able to meet the needs of many individuals who have substance abuse issues. Some individuals may prefer groups; others may prefer individual sessions. Make sure that the facility offers both group and individual therapy sessions. Ensure that the facility offers some form of social support group participation (e.g., 12-Step groups, mental health groups, etc.).

    All residential treatment facilities should either have a psychiatrist on staff or a psychiatrist who consults with the facility directly. It is important to have an idea of the particular treatment philosophy of the physicians and therapists at the center and ensure that they meet the needs of the client.

  • The facility should include aftercare in the treatment plan. Residential treatment is not the end of the line. Nearly every client entering a residential treatment program will need to be involved in some form of aftercare program once they are released from the facility. These plans should identify the type of aftercare treatment, potential providers, other resources, etc., that will be utilized once the person is released from the residential treatment center. Programs that do not offer this should be placed at the bottom of the list.

  • The facility should have scheduled visiting hours. It is important for family members to continue to visit the client. This helps to get the family involved in the client’s treatment.

Specific things to do when looking for a treatment facility include:

  • Contact your state regulatory mental health agency and review all licenses and complaints about the facility.
  • Make sure that the credentials of all the staff and faculty at the facility are available for inspection and review them.
  • Understand the philosophical paradigm the treatment providers follow.
  • If possible, ask to speak with former clients.