Selection Criteria

For this first blog I thought I’d share a checklist I compiled to help families looking for a program for their struggling teens.   This checklist comes from my family’s personal experience going through this process.   I know that finding a program for a struggling teen is an incredibly painful place for a family to find themselves in and I am truly sorry that anyone has to consider this option.   Unfortunately, as in our family, some times families feel that they have exhausted all possibilities and that they need additional support.   When we found ourselves at this junction, we chose to explore options with the help of a professional educational consultant and our daughter’s therapist.   After conducting an assessment of our daughter’s needs, the educational consultant made several recommendations of programs she felt would be appropriate for our daughter.  It was then our turn to narrow the number of programs via phone interviews and visits to the program.  The checklist below is a result of  information I found on line on the NATSAP website (National Association of Therapeutic Schools and Programs – Questions to ask before making a Final Placement Selection at http://www.natsap.org/parent_questions.asp), other web sites, and the lessons our family learned along the away.

As a note, I recognize that some parents find programs through the web.  In my opinion, the checklist below is not sufficient to address certain risks that may be present if a family doesn’t use the services of an educational consultant.   Nevertheless, I hope the checklist below is of service to some families.   Any enhancements that you may have would be appreciated.

Respectfully,

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Selection Criteria Guide
Therapeutic Boarding Schools/Residential Treatment Centers

Admissions

-What is the program’s admission criteria (i.e. what type of students are admitted to the program)?   As an example, open and closed campuses have different admissions criteria.   Also, most programs don’t mix teens with different issues.

- Is having attended a wilderness program a pre-admission requirement?

-Who reviews my teen’s application for admission? What are their credentials?

-How many students are there in the program?  Is it coed?  Programs vary in size.  In addition, some teens do better in small same sex environments.

-What are the program costs? What does this cost cover?  Note: Some programs include all cost in one fee while others don’t.  Are there other costs?  What are these additional costs?  Examples include a student fund account and specific clothing/shoes requirements (Some schools allow teens to use regular clothes and others have a dress code).

Really important: Keep receipts of everything. Certain travel expenses and the cost of the school/program may be deducted as a Schedule A Medical Expense (subject to limitations of course) – talk to your tax adviser.

-Are there student loans available (Sallie Mae, etc.)?  How are payments made (billed monthly to credit card, etc.)?

-Will a portion of the therapeutic portion of the program be covered by insurance?   Will the program bill your insurance company on your behalf?  If they are unable to bill the insurance company, can they provide you a bill with all costs split out (i.e therapy, etc.).

-How long will the admissions process take?

-Who will you be meeting during the admissions process?

-Will you be able to say goodbye to your teen after the enrollment process is complete?

-Ask for an estimate of program length.

-What is the state’s age of consent?

Licensing and Accreditation

-Is the program licensed by the State? What type of license is it?  What State office issued the license?

-Is the program accredited by a mental health agency, such as Joint Commission (JCAHO), Council on Accreditation (COA), Commission on Accreditation of Rehabilitation Facilities (CARF)?

-Does the program have a Clinical Director? What are his/her credentials? May you meet him/her?

- What are the credentials of the staff that will be working with your teen? Specifically the credentials of the counselors and/or therapists. Are they certified? Licensed within the State of the program?  If the state in which the program resides does not require licensure, what are the credentials of the staff?  Are these appropriate to the treatment they propose to offer; e.g. if they have individual or group therapy, is it provided by individuals with appropriate advance degrees (MSW, LCSW, Ph.D. MD, etc.)?

-What organizations are they affiliated with?  e.g. NATSAP

Therapeutic Model/Clinical

-Will your teen be receiving clinical therapy? How often?

-What will be expected of the parents during the program?  Note: Some programs strongly advice parents to attend regular therapy at home while their teen is away, some have parent weekends that parents are expected to attend – the goal is to create the strongest family you can.

-Does the program provide family therapy? How often?  If so, who facilitates it?  What if the parents are divorced?

-Does the program provide group therapy? How often? If so, who facilitates it? Are there specific group therapies offered? (i.e. adoption issues, drug/alcohol abuse, etc.)

- How is progress judged? Who participates in determining progress? Most programs have a “level” system or series of steps in the program that determine progress and privileges. Ask for a description of the program’s “levels” or stages of progress.

-If counseling is offered, is it provided by staff that are full time employees of the program or is it provided by adjunct or independent personnel? If the latter, is the cost included in the program’s tuition or is there an additional fee for this service?

-What is program philosophy? Behavior Modification, Positive Peer Culture. Etc.  As them to explain.

Academics

-Does the program provide an academic curriculum? If so, what is the core curriculum?

-Is the academic program accredited by a national or regional accrediting agency? Is this accreditation through a 3rd party? If so, what is their name?

-Does the academic program have in-house teachers?  If so, are they certified or licensed within your State?  Are the teachers qualified by credential or experience to teach the courses the school / program offers?

-How many students are in a class?

-Is your academic curriculum internet/computer based? We found that some schools required a laptop and others didn’t – at the end we chose one with limited use of technology.

-Do you offer junior high/high school credits that can be transferred to other educational institutions?

-Do you award high school diplomas (if applicable)?

-Are the arts a core component of the program?  Note: Some programs have a greater emphasis on the arts.

Medication

-Can my teen be on medication while at your facility?  What about non-prescription medication (e.g. vitamins, fish oil, etc.)?  How is this managed (reordering)?

-Who is responsible for the medication management? What are his/her credentials?

-Where is the medication stored? Who has access to the medication?

-Who administers the medication? What is their training?

Direct Care Staff

Note:  In my experience, the value the direct care staff brings is key as they are in the front line and develop day to day relationships with the teens.

- What type of training is provided to your direct care staff?

- What are their duties and qualifications?

- Do you perform background checks? Who does the background check? How extensive is it?

- Do you provide on-going training for your staff?

Risk Management

- What measures do you have in place to keep my teen safe?

- What are your discipline procedures with resistant students?

- How do you deal with risk-taking behaviors? (i.e. running away, self-harm, etc.) Have they had runaways and how have they dealt with them?

- What is the program’s relationship with the local police department?

- Will my teen be exposed to other students that have more negative behaviors?

- What if my teen becomes ill?  Do you have a nurse on staff? Will you transport my teen to medical facilities?

Note: We found that most programs required a complete physical prior to enrollment or shortly thereafter

Questions for Specific Program Types

Long Term Residential Specific

- Are you a locked facility?

- Is there 24-hour awake staff supervision?

- How often will I see my teen?

- Will I be able to speak with my teen on the telephone?  How often?  Is this the same if parents are divorced?  Will these calls be supervised?  If so, by whom and for how long? 

- Will I be able to write and receive letters?

- Ask about any restrictions on family communication and visitation.

- Ask about restrictions in communicating with other people (peers/family)

- How do they handle emergencies?

- What type of food do you provide?  If applicable, can the program support special dietary needs?  If applicable, does the program support a vegan diet?

Success Rate / Outcomes

- How long has your program been in operation?  Some programs that are relatively new don’t have much historical information, however, the background of some of the key staff (e.g. Clinical Director) can be so compelling that it overrides the lack of historical information for the program.  We found this to be the case for the wilderness program that our daughter attended.

- What is your success rate?  What constitutes success?

- Do you administer an outcome study? If so, what is that data?

- Do you have students return to your program?

- How do they assess student improvement and determine readiness for advancement or graduation?

Transition / Next Step

- How many of your students return home after the program?  If they don’t return home, where do they go?

- Will your program help us assess what is the next best step?

- Will I need an educational consultant to plan a next step?  Do you compensate an educational consultant for any reason?

- Do you provide aftercare?

- What contact do we have after our teen leaves your program?

Other

- Are there any extracurricular activities?  Are there social activities?

- If your teen has braces, how will these be taken care of? Also, contacts/glasses. Other special needs?

- You may want to obtain multiple sources of information about the program / school prior to enrollment. For example, you can ask for references from past clients.  When speaking with the references., keep in mind that the program probably gave you names of people that were satisfied with the program.  This doesn’t mean that there is no value to the recommendation, just that you have to look at this as one of many data points.  Another value of speaking with a former parent is that you learn about the inner workings of the program before you go on a site visit.

- If at all possible, visit a few of the programs to determine if you are comfortable with the environment, culture, methods employed, and general assessment of staff, students and climate of the school.  Can you see your teen growing here?

- When you visit the program, ask to speak to current students without staff present and ask the students what their experience is like. Ask each student what they have gained from the program, what they like the most and what they like the least.