Finding the Right Program or School

Parents (and their advisers) must thoroughly examine schools and programs before deciding which is likely to be most appropriate.  Parents should not select a school or program on the basis of superficial reputations, glossy brochures, videos, Web site information, or word of mouth.  Parents need to look deep beneath the surface and probe for detailed information from multiple, informed sources.  Hasty and impulsive choices can backfire and lead to more disruption and distress.  Parents should ask the following questions:

• How big is the school or program?  Small schools and programs generally can provide more personalized, individualized attention and close supervision and monitoring.  In large schools and programs, it may be easy for teens to “fly below the radar” and get lost in the crowd.  However, the total number of teens in a program or school may not be as important as the opportunity for small-group experiences and the amount and quality of attention the teen receives from consistent caregivers who spend time with the teen and truly know, understand, and have a positive working relationship with the teen.
• Is the program accredited and licensed?  Accreditation agencies typically require schools and programs to undergo a thorough review that includes site visits, interviews with teenagers and staff, and examination of school and program policies, programs, documents, and records.  The goal of the accreditation process is to ensure that programs and schools meet standards related to admission procedures, services provided, staffing, health and safety, facilities, governance and administration, and finances.  Accreditation does not guarantee that programs and schools are of high quality, but it does demonstrate that programs and schools are willing to undergo outside review and scrutiny and attempt to meet standards.  Prominent accreditation agencies include:
• Commission on Accreditation of Rehabilitation Facilities (CARF): CARF accredits alcohol and substance abuse treatment programs; child and youth service programs; mental health and behavioral health programs; and supported living programs.
• The Joint Commission on Accreditation of Healthcare Organizations (JCAHO): JCAHO accredits a wide range of health care organizations, including behavioral health programs that serve struggling teens.
• The Council on Accreditation (COA): COA accredits organizations that provide community-based and residential services such as alcohol and chemical dependency counseling; case management; supported and independent living; individual and family counseling; and day treatment.
• Regional accreditation agencies for independent schools:  In the U.S., educational institutions – including residential schools for struggling teens – are accredited by regional rather than national organizations (examples include the Independent Schools Association of the Central States; Independent Schools Association of the Southwest; Middle States Association of Colleges and Schools; New England Association of Schools and Colleges; North Central Association of Colleges and Schools; Pacific Northwest Association of Independent Schools; Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges).
• What are the credentials and experience of the staff?  Parents should assess the extent to which the teaching, clinical, and health care staffers have appropriate education, training, credentials, and experience.  Some schools and programs lack strict hiring criteria for teachers and other staff.  Some unprofessional and unscrupulous schools and programs may assign classroom instructors and other staff without graduate degrees in mental health professions to supervise seminars that mimic group therapy; those experiences can be destructively confrontational, emotionally abusive, and model destructive or dysfunctional communication styles and poor problem-solving skills.
• How well are staffers supervised?  How does the administration handle staff misbehavior and unprofessional conduct?  If a staff member makes a mistake (for example, curses at a teen, touches a teen inappropriately, is stopped by the police for driving under the influence), what are the program’s procedures and written policies for addressing the conduct?
• To what extent does the program or school tailor services to meet each teenager’s unique needs?  Some schools and programs wisely offer specialized services (for example, counseling, educational, behavior management) tailored to each teenager’s individual needs.  Other schools and programs, however, take more of a “one-size-fits-all” approach and use a single model with every youth.  Such programs and schools may assume a doctrinaire approach, discouraging any criticism or critical questions parents or others may ask.
• How much structure does the program or school provide?  Do teenagers spend excessive amounts of time “hanging out” without skilled supervision?
• How clearly laid out in writing are the program’s or school’s rules and disciplinary procedures?  Is the program willing to share these guidelines with parents?
• Does the program or school take a nonpunitive and compassionate approach to discipline?  Do staffers routinely label, judge, and blame teens when they misbehave (for example, “You’re a quitter, drama queen, manipulator, and lazy.”), or do they handle misbehavior constructively and firmly, without shaming, and treat the situation as a learning and growth opportunity?  Do staffers address the underlying issues that are related to the misbehavior?
• In what ways does the program or school involve parents and family?  Do staffers communicate with parents on a regular basis and involve them in key decisions?  Are teenagers allowed to communicate with parents without staff monitoring?
• How sensitive is the program or school to the teenager’s ethnicity, culture, religion, and sexual orientation?  What programs and supports does the program or school offer to support the teenager?
• How does the program or school handle teenagers’ mental health and psychotropic medication needs?  How readily do staffers recognize that teenagers’ struggles sometimes are a result of their mental health challenges?  Do staffers obtain comprehensive information about teenagers’ mental health histories and needs?  Do staffers administer psychotropic medication at the time recommended by the teenager’s physician, rather than at times that are convenient for the program or school staff?
• What is the program’s or school’s attrition rate?  Is the attrition rate unusually high, perhaps indicating program or school turmoil and instability, a punitive environment, or disgruntled parents?
• How often are teenagers truant or running away from the program or school?  High truancy and runaway rates may be evidence of the program’s or school’s ineffective or punitive methods.

Frederic Reamer Ph.D. Bio

Dr. Reamer is a professor in the Graduate Social Work Program at Rhode Island College.

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