Take a Chance on Residential Treatment

January 30, 2020

There are a lot of misconceptions and unwarranted fears that tend to arise when someone says the words residential treatment center.

What is residential treatment? How is residential treatment different than inpatient treatment? What do residential treatment centers treat?

It is not uncommon for people to relate residential treatment with institutionalization. However, these are two very different things.

In the following paragraphs, we break down what residential treatment is and how it may be able to help your child, teen, or family.

Outpatient, residential, and inpatient care: what’s the difference?

There are three commonly referenced treatment delivery methods. Each one is different, and what will work for one child or teen may not work for another. But what are the differences between the three? First, it is essential to note that one method is not necessarily better than another.  The best choice will, in the end, be the choice that most adequately meets the needs of your child and your family. One of the hardest things for parents when it comes to deciding what the best treatment options are is the idea that the “best” option may take their child further away from home than they would prefer they are.


Outpatient therapy settings allow a child to remain at home and work on their areas of concern every week or whatever frequency their family and therapist feel is best. Outpatient therapy is commonly utilized in cases where the issues being addressed are relatively minor and can be resolved in a short duration treatment period (approximately six to nine months) or semi-moderate issues, which may require a year or two to resolve. The best part of outpatient treatment, if it is a setting where the child can be successful, is the benefit of the child being able to remain at home in a familiar environment surrounded by people and situations they are familiar with.


Inpatient care settings are often reserved for cases where there is an imminent threat to self and/or others and where the person cannot contract for safety. Inpatient care is not designed to last for an extended time. Inpatient care is used for stabilization purposes, and this means this level of care often does not last for more than three to seven days, depending on the severity of the risks and the availability of supports outside of the care facility; within the family and community. Within the inpatient setting, the goal is to find ways to overcome the feelings that led to the high level of risk. This is done with psychoeducation groups, individual treatment sessions, and family meetings.


Residential treatment is used when the other two treatment methods were not successful or are not intensive enough to meet the needs of the individual. Residential care provides services on a twenty-four-hour basis. They also offer full submersion in various therapies to achieve full benefits of treatment. As with any treatment, the amount of change that occurs and the time it takes for the change to occur depends mostly on the willingness of the child or teen to participate. An essential element of success for those in residential settings is planning for the inevitable transition home.

When to take a chance on residential programs

Truthfully, there are very limited formal guidelines regarding when residential treatment may be indicated over outpatient for a particular individual. Typically, people enter residential treatment when they are in a situation where their needs are too challenging or critical in nature to be managed in an outpatient setting; however, they are not severe enough to warrant inpatient treatment. Still, others are referred to a residential treatment program upon discharge from a period of inpatient hospitalization. These are cases where the person has been deemed no longer a danger to themselves or others, but nonetheless, remain too impaired to live independently or return to a setting where medical supervision is not consistently available. For these patient’s residential treatment is used as a form of “step-down” treatment.

Some patients who enter residential treatment do so by choice. Often these are individuals who are struggling with a self -harm disorder, eating disorder or substance abuse disorder, and for whom outpatient treatment has not been successful or for whom residential treatment is a preferred treatment option.

For many of these individuals, the level of care and supervision afforded to them by residential treatment far outweighs the possibilities provided through outpatient options. Additionally, a residential treatment setting that provides care around the clock may be more comforting for a child or teen who is struggling with the recovery process.

An additional category of people who utilize residential treatment are those who have been referred from an inpatient setting to a residential treatment setting due to a medical issue that has been exacerbated due to the acute mental health or substance-related issue.

Some examples of this could include people with medical problems arising from eating disorders, diabetes, anemia, paraplegia, cerebral palsy, and brain injuries, to name a few. These individuals need sometimes need additional treatment-related not only to their mental health but to their physical health as well. Residential treatment programs such as Hillcrest have a full team of medical providers on-site twenty-four hours a day should their services be needed.

Often times, residential treatment is considered as a result of a referral from an outside source such as a private therapist, medical provider, family care physician, or even school guidance counselors and staff. Many of the referrals to residential care programs fall into one or more of the following categories.

  • The child or teen has tried outpatient treatment, and despite their best efforts, has failed to minimize or control the symptoms and impairments they are experiencing. These impairments which are associated with the person’s mental health condition can impact social and occupational functioning.
  • The child or teen who has been participating in outpatient treatment with increasing frequency and intensity has not been able to control or reduce their levels of dysfunction and symptomatic periods.
  • Emotional resources and support structures that were once available to the child or teen have become depleted or drained. These resources can include friends, family psychotherapists, psychiatrists, and various medical providers and school professionals. The loss or reduction in this support structure may be entirely unrelated to the mental condition the patient is experiencing. Unfortunately, this leaves the child or teen with an inadequate support network on which to rely during periods of increased stress or symptoms.
  • Residential treatment may be indicated for a child or teen who is experiencing a sudden onset of mental health symptoms. Still, their symptoms do not meet the criteria for acute inpatient hospitalization.
  • The child or teen may be experiencing what is sometimes referred to as diagnostic ambiguity. This means the individual is presenting with a variety of symptoms, which could be related to several different conditions. Cases like this are challenging to work within an outpatient setting as each day may present differently. In a residential setting, there is the availability of regular care throughout all hours of the day and night. The environment the child or teen is in is controlled, and therefore potential confusion related to their diagnosis and symptoms may be eliminated or clarified.
  • Safety issues are also alleviated through residential treatment settings. Safety issues are not limited to self-harm or potential harm to others. They can also include increasing levels of substance abuse, disordered eating, and other risky behaviors that can increase the overall risk of emotional harm to the child or teen. In a controlled, residential setting, these behaviors may be better controlled through the possibility of consistent observation and intervention when warranted or requested.

How to pick the right residential program

When the decision has been made that residential is indeed the right choice, as a parent, you will want to be sure the facility you choose is the best one for your child. Your mind and heart are already a sea of emotions and rightly so. The decision to put a loved one, especially a child in a treatment program that takes them away from home is hard. As a parent, you have always felt it is your job to care for your child through thick and thin; to help them conquer anything they were faced with; and most of all, to be there by their side no matter what. So, now you are torn by the emotion that you are handling some of those coveted parental duties off to someone else. It’s ok to be afraid, concerned, angry, sad, and emotional. Assuring, you have done your research into the programs you are considering will help to alleviate some of the emotional trauma you are experiencing as a parent. It is ok to admit to your medical provider that this conversation is not easy and makes you uncomfortable. Your medical provider should want to help you make the right choice through guidance, information, and support.

The truth is, the “fit” between patients, therapists, and the residential setting itself is critical to the success of the treatment program. But there is another cold truth that needs to be considered, and this element will inevitably cause your child to succeed or fail regardless of the strength of fit of the program. As a parent, you must be the biggest cheerleader for your child if they have any hope of successful and sustainable recovery.

Residential facilities also vary significantly in their goals, theoretical orientation, treatment methodologies, and supportive features offered to their patients. What is comfortable and healing for one child may not be so for yours.

Group | Residential Treatment | Hillcrest

There are certain questions you should be sure to ask or things you should look for when considering a specific program. These can include:

  • Is the program accredited and/or licensed- A sure sign of a high-quality program is its willingness to endure the scrutiny and oversight that often accompanies the state (or similar entity) licensing processes. The organizations that oversee facilities that are licensed to provide healthcare can be some of the most strict and difficult to please. To achieve and maintain licensure, programs must be willing to provide proof of their adherence to strict guidelines for evidence-based care, documentation practices, medication administration and storage practices, and many other vital aspects of residential care.
  • Fully credentialed staff- The experience of the staff members at a residential care facility should be as broad and varied as the range of patients who may walk through the doors. Practitioners need to be sensitive to all elements of patient care.
  • Access to urgent care or emergency medical facilities-Unfortunately, accidents still happen in residential care settings. Perhaps even more unfortunate are the instances of intentional self-harm that can take place in a residential program. A high-quality program will have strong working relationships with local hospitals and urgent care facilities as well as emergency response units who can transport a patient in crisis to a higher level of care at a moment notice.
  • Strong aftercare planning- treatment does not end at the time of discharge from a residential care program. In reality, the end of treatment is when the process of recovery truly begins. This can be a scary time for both your teen and you as the parent as everything they (and you) have learned during the last few weeks or months will now be tested in a less controlled environment. Relapse statistics are scary, and the only way to avoid falling into the mix is through the use of solid aftercare planning. Your chosen residential care program should help you and your teen to create an aftercare plan that includes elements of family engagement, therapeutic support, medical support, community support, and other healthy lifestyle supports. All of these should work in tandem to help your teen reintegrate into their homes and commence living their best lives.

At Hillcrest, we offer a wide range of treatment programs for children and teens struggling with addictions, substance abuse, and a variety of mental health disorders. We provide individualized treatment plans that are designed to work with the specific needs of your child and your family to ensure optimal success and recovery potential. Our highly trained staff is skilled in all areas of health, including nutrition, pharmacology, general medical needs, and of course, various mental health treatment modalities.

Through well balanced and well-rounded therapeutic treatment plans, we aim to offer the highest level of professional care possible both during and after treatment.  If you are considering residential treatment for your child or teen but are confused or concerned, that’s ok. We would like to help guide you on your next steps in the decision-making process. Give us a call and ask why residential may be right for your family.

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