{"id":2969,"date":"2014-02-04T08:49:49","date_gmt":"2014-02-04T13:49:49","guid":{"rendered":"http:\/\/graftonblog.com\/?p=2712"},"modified":"2014-10-29T11:56:42","modified_gmt":"2014-10-29T15:56:42","slug":"the-hard-work-of-decreasing-residential-lengths-of-stay-2","status":"publish","type":"post","link":"https:\/\/www.grafton.org\/the-hard-work-of-decreasing-residential-lengths-of-stay-2\/","title":{"rendered":"The Hard Work of Decreasing Residential Lengths of Stay"},"content":{"rendered":"

Parents and other agency referral sources often ask me how long their child will need residential services.\u00a0 My standard answer is, \u201cit depends.\u201d The problem with my answer is that many people disagree on what the factors are that make up my answer \u201cit depends.\u201d\u00a0 I have completed many literature reviews on factors related to lengths of stay in residential treatment.\u00a0 This research can be confusing and often contradicts previous reviews.\u00a0 Many factors have been examined including ethnicity, age, parental involvement, parental substance abuse, access to aftercare (hours\/transportation), social economic status, and child diagnosis to name a few.\u00a0 Truthfully, the research is contradictory at best.\u00a0 For example, I have read research citing age and ethnicity as primary factors in determining length of stay, only to read another article that discounts age and ethnicity.\u00a0 The same can be said for most of the other factors mentioned above. The bottom line is achieving truly time-limited residential treatment depends primarily on one thing: hard work.<\/p>\n

The first focus must always be on family engagement. Parental involvement, from intake to discharge, is critical to returning a youth to his or her home community.\u00a0 Parents must be engaged in family therapy sessions and function as true leaders of the transdisciplinary team meetings on a regular basis. We as service providers have to help make this happen, but as an industry we often don\u2019t.\u00a0 We need to offer family therapy and transdisciplinary meetings at times convenient to the family.\u00a0 We need to look realistically at the overwhelming problem of transportation to and from these important meetings.\u00a0 We need to streamline access to care and help parents wade through the minefield of securing funding for services.\u00a0 But most importantly, our teams need to see parents \u00a0as true partners, not a \u201cproblem to be solved.\u201dWe will not partner with them as \u201cpatients,\u201d only as people, people seeking ways to creatively solve problems.<\/p>\n

Community resources, supports, and opportunities for Grafton youth post-discharge are also positive,crucial parts of the hard work we must undertake.\u00a0 When the home community is able to offer professional and naturalistic supports,a young person is more likely to return to his or her community more quickly.\u00a0 Examples of these supports include church activities, afterschool activities, in-home supports, and outpatient therapy.\u00a0 My answer to the agency\u2019s question of \u201chow long\u201d should actually be \u201chow hard are you willing to work\u201d as the agency representative (CSA\/DSS\/Probation).It\u2019s all about the aftercare plan.\u00a0 As a provider, we must work with the agency representative and family to minimize barriers to community supports (professional and naturalistic).<\/p>\n

Finally, organizational factors are incredibly important.\u00a0 Is every member of the team committed to evidenced-based treatment and measuring progress and trouble-shooting impediments in coordination with the team?\u00a0 The quicker we help clients achieve functional autonomy,the quicker we can help them return to their home community.\u00a0 At Grafton, our clinical teams are committed to providing evidenced- based treatment, and we employ our goal mastery method to ensure our clients are progressing in treatment.But, as with every organization in every industry, sometimes we achieve our goal, and sometimes we fall short. The transdisciplinary team, in which the referral source and parent are essential members, is our best barometer of how our teams are doing.<\/p>\n

What generally happens with teams, especially in this era of tightened funding, is conflict. One part of the group chucks the other part of the group under the bus for perceived failures. The only solution we can muster is this: true TRANSdisciplinary treatment. Here\u2019s a graphic representation of the three usual models of care:<\/p>\n

\"private<\/a><\/p>\n

In essence, the boundaries must blur. We must all accept total accountability FOR THE CONSUMER, not for our own processes. We don\u2019t have the luxury of owning just one slice of what\u2019s happening. In essence we are all in it together, for them. And we\u2019re working hard\u2026<\/p>\n

Please comment if I\u2019ve missed something! I want to invite the dialogue, because if we can get this right, we can give a lot of people their lives back.
\nSome reading on length of stay in residential care:<\/p>\n

http:\/\/connection.ebscohost.com\/c\/articles\/17744556\/forecasting-length-stay-child-residential-treatment<\/a><\/p>\n

http:\/\/books.google.com\/books?id=D6hvEkgmioYC&pg=PA4&lpg=PA4&dq=forecasting+residential+treatment+length+of+stay&source=bl&ots=PxpUxcs3w_&sig=stERnLILZpGusLLZjQ_MAdzsaGw&hl=en&sa=X&ei=a9PrUuSVFpfNsQTkjoLIBg&ved=0CFgQ6AEwBg#v=onepage&q=forecasting%20residential%20treatment%20length%20of%20stay&f=false<\/a><\/p>\n

http:\/\/www.ctbhp.com\/reports\/CT_BHP_Literature_Review-Residential_Treatment.pdf<\/a><\/p>\n

\u00a0<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Parents and other referral sources often ask me how long their child will need residential services. My standard answer is, \u201cit depends\u201d. The problem with my answer is that many people disagree on what the factors are that make up my answer \u201cit depends\u201d. I have completed many literature reviews on factors related to lengths of stay in residential treatment. This research can be confusing and often contradict previous reviews. Many factors have been examined including ethnicity, age, parental involvement, parental substance abuse, access to aftercare (hours\/transportation), social economic status, and child diagnosis to name a few.<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[30,31,35,36],"tags":[101,123,137],"class_list":["post-2969","post","type-post","status-publish","format-standard","hentry","category-behavioral","category-behavioral-healthcare","category-mental-health-services","category-outcomes","tag-length-of-stay","tag-residential-treatment","tag-transdisciplinary-team"],"acf":[],"yoast_head":"\nThe Hard Work of Decreasing Residential Lengths of Stay - Grafton<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.grafton.org\/the-hard-work-of-decreasing-residential-lengths-of-stay-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Hard Work of Decreasing Residential Lengths of Stay - Grafton\" \/>\n<meta property=\"og:description\" content=\"Parents and other referral sources often ask me how long their child will need residential services. My standard answer is, \u201cit depends\u201d. The problem with my answer is that many people disagree on what the factors are that make up my answer \u201cit depends\u201d. I have completed many literature reviews on factors related to lengths of stay in residential treatment. This research can be confusing and often contradict previous reviews. 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