I have worked at three residential treatment centers (RTCs) in Utah from 2008 to now. I also had the opportunity to consult with various RTCs as they went through economic hardships with the downturn of the economy. I’ve helped RTCs evaluate their policies and procedures and build in improvements. I’ve also co-founded an RTC. In doing so, I have come to understand a few things.
First, lumping all residential treatment centers into one category and treating them monolithically is like lumping all restaurants together into one and treating Les Cailles as if it were the same as Taco Bell. There is an enormous variety in programs, philosophies, training and procedures.
Second, residential treatment has evolved dramatically since the 1970s, and even since the 1990s when Paris Hilton was purportedly enrolled. For most programs, the treatment programmatics have moved away from behaviorism — with token economies and a heavy focus on rewards and punishments to modify behaviors — to more psychologically sophisticated treatment methods that are trauma informed, attachment based, warm and caring. There is a trend in RTCs toward philosophies that focus on seeing people as people and responding in humane ways. Emotional safety for residents is now the prime directive of most residential treatment centers. To understand what is happening in residential treatment centers, a reader must explore the way things look within the field now, rather than a decade or two ago.
Third, most residential treatment centers that I have become familiar with have a heavy focus on family systems and dynamics. Rather than trying to isolate their students from their families and peer environments, there is a significant amount of work into helping the student and their families improve their relationships and preparing the student to be able to successfully reintegrate into the communities from whence they come.
Ryan Anderson, executive director, Telos Discovery Space Center, and process addiction specialist, Telos Programs