When many people think about out-of-home therapeutic placements they envision locked, hospital-like settings, with an impersonal approach focused on supervision. Unfortunately, this is often the perception shared by professionals within the mental health field who are unfamiliar with the current private treatment options. This is typically NOT the case with many of the newer, private programs now in existence. Many private options exist for children and young adults with special needs, with great diversity in their focus, settings, and their methods.
The goal of most private programs is to interrupt the forward progression of academic, behavioral and emotional difficulties, and build upon those skills the young person has in preparation for a healthy and independent adulthood. While actual hospitalization may be appropriate for individuals in acute crisis posing an immediate danger to themselves or others, for most young people something less drastic is optimal.
Different programs may differentially emphasize goals such as family reunification, behavior management, insight, emotional stability, etc.
Special needs settings are also varied, and include:
- Therapeutic Wilderness Programs. These programs employ skilled therapists and counselors offering sophisticated, often team-based, interventions in a challenging outdoor environment. Often therapeutic wilderness programs are employed as a first step to define goals, build momentum, and evaluate a young person's response to interventions. Programs vary greatly in their format, length of treatment, and the degree to which their interventions are confrontational. Often, students are transported by professional escorts to wilderness programs.
- Therapeutic Boarding Schools/ Emotional Growth Schools. These residential programs offer quality academics integrated with therapeutic intervention. Facilities are typically like a structured boarding school setting, with planned activities, community involvement, and support for creative pursuits. Animal-assisted therapies may also be designed into the programs, and substance abuse counseling may also be included in the curriculum. Therapeutic boarding schools usually serve students with a diversity of challenges but typically have a set of specialty offerings. Facilities are not locked.
- Home-Based Programs. Students enrolled in home-based programs typically live in residential areas with houseparent staff. Most home-based programs are small, and have a family like feel. Students in home-based settings typically attend public schools, and may have counseling from either professionals working for the program or contracted from the community.
- Transitional Independent Living Programs. These specialty programs are designed as a "next step" for students who have completed another program but are not yet ready to be independent or to return home. Transition programs are often located in communities where attending college courses is a possibility. Typically, students in transition programs may hold jobs and are involved in the community in which they are residing.
- Residential Treatment Center. These programs typically offer a more secure level of care, and are appropriate for students requiring more supervision or intensive intervention. Often, students may transition from these programs to more open levels of care after they have addressed more acute treatment issues. Facilities may include a locked unit, but typically rely on greater staff presence to offer additional supports.
- Specialty Psychiatric and Behavioral Hospitals. These facilities offer the most secure level of supervision and intervention, and may be appropriate for young people requiring immediate stabilization and evaluation.
Programs vary widely with respect to cost, typically ranging from $150-$450 per day. Staffing, opportunities for scholarships, use of non-traditional therapeutic elements (i.e., horses, ropes courses, adventure therapies), and the program's willingness to assist with insurance reimbursement also vary greatly.
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