Family members of children who have received residential services helped prepare this Family Tip Sheet so that you and others can benefit from their experience. Please use this Family Tip Sheet to help you (1) think about what is most important to you and to your child and (2) decide which questions you might want to ask when considering a residential program for your child.

If you are considering a residential treatment program for your child—or if your child has just been admitted to a residential program—you probably have many questions. This Family Tip Sheet is designed to help you get the best care and treatment for your child with emotional and behavioral challenges.

Residential programs are designed to assess and stabilize children so that families can be re-united as quickly as possible, given the needs of the child and family. The best programs work with and for families and children: they collaborate and help families discover what works to help their child flourish.

Practically speaking, there may be limits to how much choice you have about where your child receives services. If you feel strongly, though, that the plan for your child is not in his/her best interest, you should be assertive about asking for alternatives and find someone you trust who is willing to work with you to develop a safe and appropriate plan. In most cases, even if you do not have custody of your child, you still can and should be involved in making important decisions about his or her treatment.

Remember that you have the right to have a voice in the decision-making about where your child receives treatment. Don’t be afraid to ask questions or challenge policies that don’t make sense or don’t seem right to you. Work closely with providers to help your child. Many providers will be very open to your ideas and understand that you know your child best. If you run into serious roadblocks along the way, seek out a family partner, a supportive provider, or another advocate to help you.

Ideally, the answers to all of the following questions should be “yes”—but some compromises and choices may be necessary. Many excellent programs will not meet all of these criteria, but the more families and programs work together, the closer programs will get to doing so. If a program, however, is not family-friendly or the answer to any of the questions about safety or whether the treatment is right for your child is “no,” then you may want to consider other options. No one should accept unsafe, inappropriate or disrespectful treatment.

You can be a valuable and active member of the team of people who work with your child while he or she is in out-of-home care. Through teamwork, you can build a bright future for your child.

Is a residential program really the best place for my child to receive treatment right now? Are there community services that would work?

Does this particular program have the best available expertise for children with my child’s specific needs and challenges?

Is the program licensed and accredited? Have all staff had criminal background checks and have they been cleared through the state’s child abuse registry?

Are the techniques used by the program supported by research studies on children with similar needs?

Does the program make me feel like my opinion and ideas are important? Does the program involve me in decisions about my child?

Does the program empower youth to make choices and decisions while they are in residential care? Does it help them plan for their own long term goals?

Does the program build children up, not break them down?

Does the program communicate well with me and have a clear plan to consult me about important questions and decisions?

Does the program consider the strengths of our family and help us discover and build on our strengths and those of our child?

Are restraints used only when a child is truly endangering him/herself or others? Is the staff trained to reduce the need for restraints, apply restraints safely, and avoid the use of seclusion?

Will all of the people working with my child meet or speak regularly with me (and my child if he or she is old enough) as a team to talk about my child’s plan and how things are working?

Does the program offer my child appropriate educational opportunities while s/he is in care? What steps will be taken to be sure my child has a smooth transition back to a school in the community afterwards?

How is the program going to support us when our child comes home? Does the program keep children involved in community activities even when they are in care? Does the program prepare adolescents to live independently?

Does the program understand that many children have experienced overwhelming stress and/or trauma? Does the program avoid situations that can re-traumatize children?

Does the program work with my child’s doctors and others to learn his/her medication history prior to admission? Is the program using medications safely and appropriately?

Does the program track whether my child is making progress towards his/her goals and make changes when needed? Can the program clearly describe what the criteria are for discharge? What will happen if there is a disagreement about my child’s readiness for discharge?

To get answers to your questions or to contact an advocate who can help you learn more about how you can find the most effective services for your child, please contact:

The National Federation of Families for Children’s Mental Health at

Thank you to the many family members, residential program staff and others who reviewed and contributed to this work. This effort was undertaken as a part of the national Building Bridges Initiative (BBI) which is supported by the Child, Adolescent and Family Branch, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. This Family Tip Sheet is a product of the BBI, a national effort supporting strong partnerships between residential and community providers, policy makers, advocates, families and youth towards implementing practices that are family-driven, youth-guided, strength-based, culturally and linguistically competent, individualized, evidence and practice-informed, and consistent with the research on sustained positive outcomes.

For more detailed information about the topics addressed in this Tip Sheet, please see Family Tip Sheet on Residential Programs: More Information for Families and Caregivers; this expanded Family Tip Sheet and other materials about the national Building Bridges Initiative are available at

Oversight and partial support for the Building Bridges Initiative comes from the Child, Adolescent and Family Branch of the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.