Inside Info on the Residential Programs from Youth Who Have Been There
Starting residential treatment can be hard, so knowing what to expect can help. You might feel alone or angry or scared, and you may be concerned that no one will listen to you and your concerns. We have been right where you are now. We put this information together to help you benefit from our experience.
Going into a residential program is a big change for anyone. When you know what to expect, it can be a lot less scary and you will be able to benefit more from your experience. Don’t be afraid to ask questions and take care of yourself. You deserve the best!
The questions below can help you understand what to expect and help you talk about issues with your program, so that you can successfully take charge of your recovery.
Questions You Might Want to Ask Yourself and Others
- How is this program going to help me?
Some youth are in a residential program to deal with specific problems. Sometimes youth agree that they need to work on those problems and sometimes they do not; youth goals and family goals may also conflict with one another. Some youth are sent to a residential program by parents, schools or courts. No matter how you got here, once you are in the program it is important to find out what kinds of changes the program is trying to help you make and what supports and services will be offered to you. You have unique strengths and needs. Talk to different people you trust to help you decide what your goals should be while you are in the residential program. You should evaluate whether the program will meet your individual goals, and work with your family, care coordinator and staff to ensure that the services and supports that you believe you need are provided.
- What factors determine how long I’m going to stay here?
Right from the start, ask how long you are likely to be in this program and what factors will determine when you can go home. Some research shows that shorter lengths of stay are more effective. You might want to stay for as short a time as possible or you may prefer to stay longer. The length of time you stay should fit your needs. Ask how you can have a say in how long you stay.
- What goals do I have for myself? Is this the best place to help me reach my goals?
Think about what is important to you and identify your personal goals. Then ask how this program will help you achieve your goals. Find out if this program has been successful in the past in helping other youth to reach similar goals. Ask if it is possible for you to get the help you need while living at home. Be sure to discuss your options with the adults involved in making this plan with you.
- How can I be involved in decisions about my treatment?
A group of people will meet to discuss the plan for your care. This group is called a “treatment team”. You have the right to be a part of this team, to have a voice in who else is on this team, and to ask to have someone you choose to support you attend team meetings. That person can be a friend, a relative, or an adult you trust. Your team should also include teachers, counselors and other people who have worked with you and your family outside of the residential program. You should know how to contact everyone on your team. You have a right to help decide what goals are in your treatment plan and to have a copy of the plan. The plan should be reviewed often so you can make changes to help you meet your goals. Some youth lead their own team meetings. Others might feel uncomfortable speaking at these meetings. If you are not comfortable speaking up, tell a trusted staff person or your support person what you want to discuss before the team meeting. Then, he or she can help you start the conversation.
- What can I do to make the most of my time here?
Ask to be involved in all of the decisions that affect you. Be clear about what you think you need and what will work best for you. Also, when people feel like they have control or “ownership” of their treatment, they do better. Some programs have youth advisory boards or opportunities for youth who have been in the program longer to help those who are just starting the program. If you are interested, get involved; many people find this makes a big difference in how they feel about their experience.
- How can my emotional and physical needs be met so I feel safe and comfortable?
Try to figure out what situations make you feel positive and happy as well as what makes you feel uncomfortable or more likely to violate rules. If things like being touched or being spoken to in a certain way upset you—or if there are things that soothe or calm you, like listening to music or talking to a particular person—tell a favorite staff person so he or she can help you get what you need.
- What are the rules of this program? Who makes the decisions about the rules? Do I have a role in making the rules?
Programs often list youth rights and responsibilities on signs and in handbooks (Check out the Client Rights section of our informational handbook). These should be explained to you clearly. If you don’t understand something, ask for an explanation. You should not be expected to follow rules you don’t know or do not understand. You can also ask what the rules are for the staff. Anytime groups of people live together, some rules are needed so that everyone can be safe and feel comfortable. Youth in the program should have a voice in developing the rules and deciding how to support each other to follow the rules. The most effective rules are those that are created by everyone in the group.
- How does this program discipline youth? How will the staff help me to do my best?
Programs vary widely on discipline. Ask for help if you have trouble with particular rules and try to discuss ways to make the program work better for you. Sometimes rules don’t make sense or they exist because “that’s the way we’ve always done it.” Don’t be afraid to ask about the purpose of these rules. Isolation, restraint and humiliating or degrading treatment should never be used for punishment. If you feel you have been subjected to inappropriate discipline, tell your family, guardian, or care coordinator and/or make an official complaint.
- What kinds of choices do I have? Does this program support youth in making their own choices?
Residential programs are at all different levels when it comes to providing youth with choices about their treatment, educational, and living arrangements. Some residential programs give youth the choice of whether they even want to be in the program. Some residential programs offer youth choices in the food that gets served, curfews, recreational activities, what housing unit to live in, the classes that they are able to take, and many other opportunities for youth to exercise their right to choose. You should be able to ask someone at your program what choices you will have and how you can advocate for more opportunities to make choices. There may be reasons why a choice isn’t being offered to you. At a minimum, you should always receive a respectful, thorough answer when you aren’t allowed to choose something.
- How will I be educated while I’m in this program? Will you ensure that my credits transfer to my school, so that I don’t fall behind in my educational progress?
Some residential programs use schools in the community. Others provide schooling themselves. Right up front, find out who is in charge of education and ask how you will get the classes that you need for graduation. If you are not able to attend your regular school, find out how credits and grades transfer to your regular school. Also, find out whether this program helps with college preparation and/or teaches skills like driver’s education and job training. Planning for a smooth transition home should begin as soon as you enter the program.
- How will you make sure that I can stay in touch with my parents, siblings, friends and other important people in my life? How will they fit in to what goes on here (e.g., policies, spending meaningful time with my family, decision-making)? What if there are people I don’t want to see?
Research shows that keeping people connected with family, friends and community is helpful to recovery (except in obvious situations like contact with people who are abusive or who are not helping you to accomplish your goals). Ask how this program can help you spend time with your family, even if you are far from home. Programs should never limit contact with your family; you have the right to spend meaningful time together and to communicate frequently with your parents or guardians, siblings and other loved ones (unless a court has ordered otherwise). If you or the program want to place any restrictions on with whom you can communicate, or who you do/don’t want to see, this needs to be a part of your treatment plan and you should have a voice in the meeting where that topic is discussed.
- What therapies and medications will I receive and what are they for? What choices do I have about my therapies and medications?
Programs use many different therapies and medications, but they sometimes don’t explain why they do so. Some treatment approaches (or therapies) are more effective for certain needs. Ask how this program will work with you and your family to achieve the best outcomes based on your unique strengths and needs. You should receive care that fits your individual needs. If something makes you uncomfortable or doesn’t seem right for you, ask about it and have staff explain. If you are receiving medications, make sure you are provided with information about the medications, what they are used for, and if there are side effects to watch for. It is important that you let staff know if the medication is helpful or not. If medication is not working, ask to see the doctor who prescribed the medication and explain the situation to the doctor. In some places, you may have the right to refuse medication.
- How will this program respect my culture, my beliefs, my sexual orientation and my gender identity?
Everyone has a culture. Your culture includes many aspects such as your language, your ethnicity, your values, your beliefs, the food you eat, the customs that are important to you, and the unique way you and your family live your lives. The most ‘culturally and linguistically competent’ programs have a diverse staff that has been trained to show respect for you and for your culture. All programs should provide services to you in your own language. You should be supported to practice your religion through access to services, honoring dietary rules, etc. Any youth who is lesbian, gay, bisexual, transgender, questioning, intersex or two-spirit (LGBTQI2- S), has the right to be safe and treated with dignity and respect. Ask whether staff has had diversity training that includes sexual orientation and gender identity. Ask how this program handles bullying and whether they have provided services to other youth who are LGBTQI2- S.
- What do I do if I feel I am being treated unfairly by staff or if I have other problems with this program?
First, make sure you deal with the problem in the calmest way possible. If you make your complaints in an aggressive or disrespectful manner, staff may not take your concerns seriously. All programs should have a well-defined “grievance” process for making complaints. This process should not involve having to complain to the person with whom you have the problem! Some programs have a “youth advocate” or “ombudsman” for this reason. If something is bothering you, go through these channels first; then if you do not get satisfactory answers, try to talk to the director of this program. If you can, tell your family or care coordinator. Try to be as specific and detailed as possible and express your concerns clearly and calmly. You have the right to have your complaints heard and addressed. If you feel that you or someone else is being abused or if there is a serious health or safety risk, call your state’s child abuse hotline or call the police. If you are in the custody of child welfare or social services also let your child welfare social worker know about your concerns.
- Does this program use seclusion (isolation) or restraint? If so, what is done to prevent their use?
Many programs are working to reduce restraint through training for staff and with suggestions from youth and families. Staff are trained to supervise clients closely to identify problems before they begin, and we do our best to intervene proactively to avoid unsafe behaviors. However, at times these incidents are impossible to avoid, and staff use restraint or seclusion as a last resort when needed. Restraint or seclusion should never be used as punishment. If there are certain events, people or situations which have made you lose control in the past, inform your family, care coordinator and staff about these “triggers” so that they can be avoided whenever possible. If you have learned ways to defuse situations or ways you can be comforted, share those ideas with staff and with your team. If restraint is ever used, there should be a “debriefing” where you can talk about what happened and how staff and/or you can do things differently to prevent future incidents. If you feel that seclusion and restraint are used too often or inappropriately, tell your family, guardian, or care coordinator and talk to staff, if possible.
- What if I find a particular therapy to be too painful or unhelpful? Whom should I approach with my concerns?
People who have had past traumatic experiences may become overwhelmed if they do not feel safe and in control. Help program staff understand how to make you feel safe. Tell them when you are not feeling ready to talk. You do not have to accept any label or view of yourself that does not feel right to you. If something isn’t working for you, talk to your parent or guardian and also to your care coordinator or a member of your team. Of course, everyone sometimes has to deal with difficult issues and emotions to move forward in life. Some therapies take you out of your “comfort zone,” and it is important that you feel safe and can trust the people around you. It is not appropriate for treatment to push you into intensely distressing disclosures or overwhelming experiences of shame or dread. Therapy can be hard—it should not be unbearable.
- How will this program help prepare me to go back to my school, to college, to work, or to live on my own and handle finances?
Throughout the entire time you spend in a residential program, the program should be supporting you and your family in preparing for a successful transition home or to living independently in the community. Many residential programs are working to keep youth in their own schools, or at least in a community school similar to their own school. Inquire if this is possible for you. From the moment you are admitted, this program should be supporting you and your family to transition to the school that you will attend when you are no longer in the residential program, or to a college, trade school, or job training program. Throughout your time in a residential program, you should have the opportunity to learn and use practical skills (e.g., manage your own money; looking for a job and work skills; doing your own laundry; managing your time; taking public transportation; pursuing individual interests and developing your talents in community locations). Youth in residential programs should be encouraged and supported to participate in activities that are ‘normal’ for their developmental age and similar to what their peers are doing who live fulltime in the community. Many states have services or information for youth leaving a residential program (sometimes called independent living services or transition services) to help you to learn the skills you need to live successfully on your own when you leave the residential program. Ask for details about these services and their availability.
- How can I maintain the connections I make with particular staff?
Many youth become close with particular program staff. It can be good to stay in touch and it is OK to ask about how to do this.
- If I think my program is not right for me, whom can I talk to and how can I advocate for myself? Who is here to help me if I have a problem?
If you feel that you are in a situation that is not helping you, talk to your family, child welfare social worker, or care coordinator and explain the reasons why you feel this way. Talk to more than one person, so you can be sure that your needs are heard and understood. Try to discuss these issues when you are not upset or in a crisis. Ask the program staff or someone on your team to consider what your needs are, how you came to be in this program, what you need help with and how you could get those needs met in a different setting. The important thing is to talk to people and find a program that works for you.
For Help and Additional Information
If you have safety concerns, call your state’s child abuse hotline or dial 911.
For more information on youth leadership and advocacy, you can contact:
This Tip Sheet was written by the Building Bridges Youth Advisory Group.
Visit the Building Bridges Initiative website www.BuildingBridges4Youth.org where you will find more resources.