How to Select a Residential Treatment Center, A Parent’s Essential Guide to Accreditation and Compliance

Navigating the complexities of teen mental health can lead parents and caregivers to consider Residential Treatment Centers (RTCs). This comprehensive guide answers the crucial question, “How to select a Residential Treatment Center?” With this guide we provide essential information on what RTCs are, the types of challenges they address, the key factors to consider when choosing a TRTC center (using RTC accreditation and regulatory compliance as guidance.) These resources help you make informed decisions for your child’s well-being. Understand the purpose, benefits, and critical considerations involved in selecting a residential treatment center that can provide the specialized support your teen needs to heal and thrive.

Why Accreditation Matters: Your Assurance of Quality and Safety in an RTC

Think of accreditation as a “seal of approval” from independent experts who have thoroughly reviewed an RTC’s practices and standards. Choosing an accredited facility significantly increases the likelihood that your teen will receive high-quality care in a safe and supportive environment.

Ensuring Quality of Care

Accreditation standards are built on proven best practices and evidence-based approaches. RTCs that earn accreditation demonstrate a strong commitment to providing effective treatment, from the initial intake process and personalized treatment plans to the crucial elements of therapy and discharge planning.

Promoting Your Teen’s Safety

Safety is paramount. Accreditation organizations place a significant emphasis on ensuring RTCs have robust safety protocols in place. This includes managing risks, handling medications responsibly, preparing for emergencies, and creating a consistently therapeutic and secure setting for your child.

Building Credibility and Trust

When an RTC is accredited by respected bodies like The Joint Commission or CARF, it signals to you, to referral sources, and to the wider community that the center has met rigorous standards. This independent review process fosters greater trust and confidence in the facility’s commitment to professionalism and quality care.

Facilitating Regulatory Compliance and Funding

Accreditation can often help RTCs meet state licensing requirements and become eligible for funding from insurance providers and other sources. Many payers prioritize or even require accreditation, making it a practical consideration for accessing services.

Driving Continuous Improvement

Accreditation isn’t a one-time achievement; it’s an ongoing process. Accredited RTCs are committed to regularly evaluating their performance, identifying areas for growth, and implementing changes to constantly improve their services. This dedication to continuous improvement benefits your teen’s treatment journey.

Attracting and Retaining Qualified Staff

Accredited facilities often attract highly qualified and dedicated professionals who value working in an environment that prioritizes high standards and best practices. This commitment to quality also supports ongoing staff training and development, leading to a more skilled and engaged team caring for your teen.

Recognized Residential Treatment Center Accreditation Organizations

When evaluating RTCs, confirm their accreditation status with one or more of these reputable organizations:

The Joint Commission (TJC)

A leading non-profit organization that accredits a wide range of healthcare programs across the U.S., including behavioral health services like RTCs. Their “Gold Seal of Approval” signifies a high standard of quality.

CARF International (CARF)

An independent, non-profit accreditor that reviews health and human services internationally, including behavioral health and youth services. CARF accreditation indicates a commitment to continuous improvement and quality outcomes.

Council on Accreditation (COA)

An international non-profit accrediting body focused on human and social service programs, including RTCs. COA emphasizes service excellence and ongoing quality enhancement.

Accreditation Commission for Health Care (ACHC)

A national organization providing accreditation for various healthcare providers, including behavioral health facilities. ACHC focuses on a collaborative approach to achieving accreditation standards.

Understanding and Monitoring RTC Regulatory Compliance: A Parent’s Vigilance

Beyond accreditation, Residential Treatment Centers must also adhere to federal and state regulations. As parents and caregivers, it is crucial to understand these requirements, check for a facility’s compliance before placement, and actively monitor their continued adherence to these standards once your teen is in their care.

A Parent’s Cautionary Tale: The Cost of Non-Compliance

One parent’s recent experience vividly illustrates the importance of vigilance. Initially, an RTC appeared compliant with regulations. However, several months into their teen’s stay, the facility owner reportedly began cutting essential services to increase profits, disregarding legal and regulatory obligations. This resulted in five months of wasted time with minimal actual treatment provided. Despite regulations requiring weekly individual and family therapy, and daily group therapy and education, this teen received a mere two hours of individual therapy in five months, no family therapy, and lacked consistent group support and education. The required licensed clinical director resided out of state, and for extended periods, no licensed therapist was even present at the facility. A mandated treatment plan was also never provided. This heartbreaking experience underscores the critical need for parents to be informed and proactive.

Existing Federal Regulations and Oversight

While a single, overarching federal law for all RTCs is still evolving, several key federal entities and legislation provide guidance and set standards:

Substance Abuse and Mental Health Services Administration (SAMHSA)

As part of the Department of Health and Human Services (HHS), SAMHSA offers valuable guidance and resources for behavioral health treatment, including for adolescents. Their focus on evidence-based practices, trauma-informed care, and protecting client rights influences the standards of care in RTCs.

Department of Health and Human Services (HHS)

HHS oversees various programs and regulations impacting RTCs, particularly concerning Medicaid funding and safeguarding client well-being. Regulations like HIPAA are vital for ensuring the privacy of your teen’s health information.

The Family First Prevention Services Act (FFPSA)

This 2018 federal law aims to prioritize family-based care and has implications for federal funding of congregate care settings. FFPSA promotes the use of Qualified Residential Treatment Programs (QRTPs) that meet stringent accreditation and evidence-based, trauma-informed care standards.

Stay Informed: Resources for Investigating RTC Compliance and Safety

Given the potential for inconsistencies and the importance of your child’s safety, it is highly recommended to research any RTC you are considering through these non-profit organizations that provide national database information regarding facilities with compliance issues, lawsuits, news stories, and survivor accounts:

Unsilenced

Unsilenced is dedicated to serving victims of institutional child abuse, with a focus on the Troubled Teen Industry (TTI), a network of often unregulated facilities claiming to help youth with mental health or educational challenges.

Breaking Code Silence

Breaking Code Silence is a network of survivors from the “troubled teen industry,” including wilderness programs, RTCs, therapeutic boarding schools, and other privately-owned facilities.

Navigating Utah’s Regulatory Requirements for Residential Treatment Centers

Each state has its own specific regulations governing RTCs. In Utah, these rules are established to protect the health, safety, and well-being of youth in care. While specific details can be found in the official documents of the Utah Department of Human Services (DHS) and other relevant state bodies, common areas addressed include:

Staffing Requirements

Utah regulations typically outline the necessary staff-to-client ratios, the qualifications and background checks required for staff, and the ongoing training expectations for clinical, direct care, and administrative personnel.

Clinical Services

Specific requirements often exist for the provision of therapeutic services:

Individual Therapy

Regulations may mandate a minimum of one hour of individual therapy per week for each resident, or as specified in their individualized treatment plan.

Family Therapy

Regular family therapy sessions, often at least one hour per week, are typically required to ensure parental or guardian involvement in the treatment process.

Group Therapy

Standards for group therapy often include a minimum frequency (e.g., one hour per day, five days a week), structured scheduling, and may include specific requirements for exercise (e.g., once a day, five days a week) and education (e.g., a minimum of four hours daily).

Educational Services

RTCs providing educational services must adhere to the standards set by the Utah State Board of Education to ensure residents receive appropriate academic instruction, especially those with special education needs.

Daily Activities and Structure

Utah regulations often emphasize the need for a well-structured daily schedule that balances therapeutic activities, education, and opportunities for recreation. This may include specific guidelines for:

Physical Exercise

A dedicated amount of time for physical activity or exercise each day is often required to promote the physical and mental well-being of residents.

Recreational Activities

RTCs are generally expected to provide opportunities for leisure and age-appropriate recreational activities.

Safety and Security

Maintaining a safe and secure environment is a key regulatory focus, covering facility safety protocols, emergency procedures, crisis intervention techniques, and strategies for managing challenging behaviors.

Medication Management

If an RTC handles medication, strict regulations govern the safe storage, accurate administration, and thorough documentation of all medications.

Record Keeping and Confidentiality

Utah regulations mandate the maintenance of accurate and confidential client records in accordance with state and federal privacy laws, such as HIPAA.

Incident Reporting

RTCs are required to have clear procedures for documenting and reporting significant incidents, including injuries, runaways, and allegations of abuse or neglect.

Empower yourself with knowledge. By understanding the importance of accreditation and diligently reviewing and monitoring regulatory compliance, you can make a more informed and confident decision when choosing a Residential Treatment Center for your teen. Your active involvement is crucial in ensuring their safety and the effectiveness of their treatment journey.

Sources & Citations 

1. Fonagy, P., Cottrell, D., Phillips, J., Bevington, D., Goodyer, I. M., Dunn, G., & Kraamwinkel, N. (2016). The impact of intensive residential treatment on attachment and mental health outcomes in adolescents with severe and complex mental health problems. Child and Adolescent Mental Health, 21(3), 135-143. https://doi.org/10.1111/camh.12134
2. This study examines the effectiveness of intensive residential treatment for adolescents with severe mental health problems, focusing on attachment and mental health outcomes. It provides insights into the potential benefits of this level of care for specific populations. ** গড়াগরি, এস., & শেখ, এম. (2023). Effectiveness of residential treatment programs for adolescents with behavioral problems: A systematic review. Children and Youth Services Review, 145, 106762. https://doi.org/10.1016/j.childyouth.2022.106762** This systematic review synthesizes findings from multiple studies on the effectiveness of residential treatment programs for adolescents exhibiting behavioral problems. It can offer a broader understanding of the outcomes associated with these programs and potential factors influencing their success.
3. Substance Abuse and Mental Health Services Administration. (n.d.). Treatment. SAMHSA offers resources and information on various levels of care for mental health and substance use disorders, which can include descriptions of residential treatment.
4. National Institute of Mental Health. (n.d.). Mental Health Medications.
5. While not solely focused on RTCs, understanding medication management is often a component of care in these facilities. NIMH provides reliable information on this topic.
6. The Joint Commission. (n.d.). Behavioral Health Care Accreditation.
7. Information from The Joint Commission outlines their accreditation standards for behavioral health organizations, including RTCs, and explains the importance of accreditation.
8. CARF International. (n.d.). Behavioral Health. CARF provides details about their accreditation process and standards for behavioral health programs, including residential treatment.
9. Council on Accreditation. (n.d.). What We Accredit. COA offers information about the types of human and social service programs they accredit, including residential treatment, and their focus on quality.
10. Utah Department of Human Services, Division of Substance Abuse and Mental Health. (Current Year). Residential Treatment Programs Rule (R501-19). Retrieved from https://adminrules.utah.gov/public/rule/R501-19/Current%20Rules?searchText=R501-1 This specific state regulation provides insight into the operational requirements and standards for RTCs within Utah, offering a concrete example of regulatory oversight. Remember to update “Current Year” with the actual year.
11. Unsilenced. (n.d.). About Us. Information from this organization highlights concerns within the “Troubled Teen Industry,” including some residential treatment centers, and provides context for the need for careful selection and oversight.
12. Breaking Code Silence. (n.d.). About Us. Similar to Unsilenced, this survivor-led network offers perspectives on institutional abuse within the TTI, underscoring the importance of due diligence when considering RTCs.

About The Author

Cheryl Nunn brings a unique blend of seasoned leadership and cutting-edge AI & MBA proficiency to her consulting practice. As a former CEO of a thriving publishing company, she has a proven track record of driving growth, optimizing operations, and fostering a culture of success. This real-world experience, coupled with a deep understanding of business dynamics, forms the foundation of her writing and consulting work. Cheryl Nunn brings a unique blend of seasoned leadership and cutting-edge AI proficiency to her consulting practice. Learn more about Cheryl’s expertise at her LinkedIn Profile or on our “About Us” page.