Academic journal article Curriculum and Teaching Dialogue

A Portrait of Residential Treatment from a Youth Perspective

Academic journal article Curriculum and Teaching Dialogue

A Portrait of Residential Treatment from a Youth Perspective

Article excerpt

INTRODUCTION AND CONTEXT

An estimated 634,265 people live within Denver County, the location of the state capitol. Adorned with a copper-crusted dome, situated at the intersection between Colfax and Broadway, in the heart of downtown, the city projects a bustling vitality. Yet, just across the street is Denver's Civic Center Park, which boasts a Greek-style open-air theater, a throwback to an older age of abundance, now the gathering place of drug dealers, users, and homeless individuals within the city. In 2009, there were an estimated 4,000 homeless individuals, 800 of which are youth, living in Denver on any given day (Day, 2009; Urban Peak, 2013). Many of them stayed in Denver's Civic Center Park overnight, until sleeping outside became illegal on July 1, 2012. A few miles further south on Broadway, Urban Peak's Denver homeless shelter is located in a large rectangular one-story building, half red brick and half beige siding, across the street from a Comcast building. Urban Peak was founded in 1988, and serves youth between the ages of 14 to 24 years old by providing essential services, such as meals, job training, a shelter, counseling, and housing programs. Mental health assessment is a prerequisite for eligibility for housing, as housing programs are based upon diagnostic criteria, which led me to talk with many of the youth at the shelter.

My experiences as a psychologist-in-training at Urban Peak provided me with an inside look at homeless youth. I often saw clients who had grown up in the social services and juvenile justice systems who went on to experience homelessness. As I sat huddled in my tiny windowless office interior office with marred off-white walls, bundled up in my jacket and mittens during the winter due to the poor heating system, on an office chair that could barely swivel, I could almost taste what it felt like to be in their shoes on the streets as they courageously shared their stories. I found myself deeply troubled that the seemingly substantial efforts and years of treatment received could so easily lead to such negative, risky outcomes. Such experiences led me to explore the ways in which current research on the effects of Residential Treatment Centers (RTCs) and other programs has fallen short of providing a space for the voices of its clients. Thus, the present study was conceived to illustrate one such voice of experience.

LITERATURE REVIEW

Residential treatment centers (RTCs)--also called rehabs or live-in treatment programs--are a last resort for children who have been unsuccessful in other settings. But research is lacking on their effectiveness (Sternberg et al., 2013). Many programs conduct no research regarding their efficacy, and are limited by available resources (Sternberg et al., 2013). Programs may employ evidence-based therapies as part of their programs, but the residential milieu, the largest portion of the program, lacks research support. Whitehead, Keshet, Lombrowski, Domenico, and Green (2007) argued that a lack of a clear definition of appropriate residential treatment contributes to systemic failing and institutional abuse. Another study argued there is no documented efficacy of residential treatments and significant concerns about adverse iatrogenic effects (Pumariega, 2007). When gains are made, youth struggle to use their newly learned skills outside the treatment environment (Pumariega, 2007). Weis and Toolis (2009) found that youth with conduct problems that voluntarily participated in a military-style residential treatment program maintained gains at six-month follow-up, but those gains had diminished by 36 months. Aftercare services are needed for youth to generalize skills and maintain gains (Sternberg et al., 2013).

RTCs frequently employ the use of a level system, in which youth earn increasing privileges and responsibilities based on good behavior, or a Positive Peer Culture, where youth at higher levels motivate the youth at lower levels to engage in appropriate behaviors. …

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