Creating Safe Residential Programs for Teens

By Virginia Avizu, Vanessa Gonzalez, Jessica Herrera, Karen Rebollo, MSW, California State University, Long Beach

The Stop Child Abuse in Residential Programs for Teens Act of 2018 was created to amend the Stop Child Abuse in Residential Programs for Teens Act of 2008. To truly protect adolescents from harm in residential programs, we have established further standards to the original bill. Three new objectives added will increase support and access to all youth who qualify for residential treatment.

First, the 2018 act will implement 2–3 annual randomized inspections in teen residential programs to monitor documentation, treatment plans, safety regulations, ensure up-to-date abuse protocols and conduct random confidential interviews with clients. With residential treatment programs undergoing two to three randomized inspections each year, youth will benefit from treatment that is under continuous supervision.

Second, this act will require that at least one LCSW is on staff in addition to one MSW for every 20 residential treatment participants.

Third, this new act will implement group interventions, based on symptoms and diagnosis, to teach and enhance coping skills, social skills and interpersonal skills. Commonly, youth who are seen to have poor social skills are stigmatized as “bad” kids.

In the original 2008 bill, some of the set goals were to reduce child abuse, which entailed withholding necessary elements for survival, and not telling parents of treatment practices such as medication changes. The programs targeted are programs designed to address behavioral problems linked to emotional, mental health, alcohol and/or substance use. With these specific criteria at hand, it is important to reduce treatments that cause trauma in the already distressed teens. To better serve the teens, programs need to have interventions specifically for their symptoms, so they can have healthy, long-lasting skills. The 2018 act will increase social justice for all youth under the age of 18 who are in need of intensive, residential treatment to treat emotional, behavioral, mental health and/or substance abuse problems. This will ensure that proper and ethical treatment is being administered and that child abuse and neglect do not occur.

The original policy contained unintended consequences of high turnover rate of staff in residential programs and the continuation cycle of abuse. Having one licensed and one master’s level social worker for every 20 residential treatment participants will prevent staff burnout and high turnover rate. As staff receive sufficient support and assistance from each other, their professional development and work ethic increases. With a decreased turnover rate, clients can learn to build long-lasting relationships with trusting adults and benefit from unconditional support. Additionally, staff would be more alert on duty, so they will be better able to recognize the signs of needed client support to prevent and reduce unethical treatment.

Moreover, implementing the policy change of more randomized inspections in teen residential programs will assist in eliminating the cycle of abuse and neglect. As more inspections are performed, residential programs have to keep up with their documentation and treatment plans, which leads to accurately performing the evidence-based practices. This will lead to more consultation between social workers and staff and minimize any harmful practices that lead to child abuse.

With this alternative policy, a few unintended consequences can occur. A decrease in abuse from the numerous inspections a year can cause an increase in the enrollment for teen residential treatment programs; therefore, there is possibility for long waitlists for programs due to high demand. As waitlists increase, this can also cause for insufficient number of beds per residential program. Further, with a higher rate of clients going into these programs, there may be unclear discharge plans or goals not fully met residential programs try to get in as many clients as possible with a short-term plan, to expedite the number of clients going in and out of the program.