7 Steps to Help You Find Residential Treatment

Paris Hilton testified before the House committee on ways and means about the abuse she experienced as a teenager in 4 different residential facilities for “troubled, rebellious” teens. This is something she’s talked about before, because of the traumatic experiences she endured. 

If you read my book, you may remember the moment when the director of the eating disorder day program my daughter was attending made the “suggestion” that she be transferred to residential treatment. (I put quotes around the word suggestion because it was no suggestion.) And it was true that Faith’s self-harming behavior had escalated to a point where the entire treatment team and my husband and I feared for her life. 

So fighting tears, I took the Post-It Note from the director’s hand, inscribed with the facility name and phone number, and headed home. The next morning, I made the call and got the process started. A day or two later, sight unseen, we arrived at the place with our terrified fourteen-year-old daughter in tow. 

Hindsight is 20/20, and two disparate things can be true at the same time:

• I regret our decision. It hurt our daughter and it hurt us.
• And, I know that given the same circumstance, I’d make the same decision again.

We chose what we believed at the time was the safest course of action.

It’s an impossible position to be in, really. Balancing the desire to help our child with the guilt and anxiety of separation. Thinking the best way to help her was to send her away from her home and everything she’d ever known. While our intention was obviously not to cause our daughter more harm, that is in fact what happened. During the worst, most vulnerable time of her life, we gave her the message that she was “so bad” she had to leave.   

If you or someone you know is in the process of dealing with this scenario, please know that I see you and your pain. Below is information and a few suggestions I wish I’d had at the time. That I hope will help you if you need it.

Make sure you see the location. Unless there is a significant reason why you cannot see the residential facility first, do not agree to anything without showing up in person. They should welcome you and the conversation with openness. If they don’t, take heed.

When you get there, take a good look around. Is it clean? Does it have adequate security? How do they staff and handle the overnight hours? Don’t be afraid to ask questions. As basic as this sounds, make sure the facility specializes in your child’s diagnosis. For example, eating disorders may be handled at a separate location from other mental health conditions. Talk to the staff about your child’s symptoms.

If the professionals throw diagnoses around in a willy-nilly manner, take heed. Ask about their approach, how they develop rapport with their clients. If they don’t have adequate answers, take heed. Do they present in a thoughtful and dignified manner? Ask for clarity on the minimum and maximum durations of care. What do they do if they feel treatment isn’t working? How, exactly, do they handle dysregulated, chaotic behavior? Will your child get a personalized treatment plan or does the facility lump all the kids together under one treatment umbrella? Take notes and discuss the answers with whoever is making the recommendation for residential placement.

You can also visit The Joint Commission website (jointcommission.org) and click the tab in the upper righthand corner that says, Find Accredited Organizations. You can then search the database by organization name, city, state, or zip code. 

Why is this important? Because, if you end up having safety concerns about the location or staff, you can file a complaint. More on this below.

Check Yelp or other websites where regular folks like us leave reviews. Someone who leaves a bad review could have a bone to pick that is unrelated to the quality of care provided.

But sites like these can be invaluable sources of information. I wish I’d checked prior to bringing my daughter to the first facility, and I ultimately did leave a poor review. Know that they’re looking. Many months after I left that poor review, I was contacted by the person hired as the residential treatment facility’s new director.

If necessary, you may need to file a complaint with The Joint Commission.  I did, against that first residential treatment center. I doubt I was the only parent to do so, and I know the location was investigated.

The Joint Commission only accepts complaints regarding safety. In other words, they will not investigate a location if you disagree with treatment protocol, have billing issues, or feel like the treatment isn’t working. 

First you’ll need to collect the required information. Then you can Report a Safety Patient Concern on their website. Be sure to take good notes throughout the entire placement process. 

Listening to your instincts can be very hard to do when your child is struggling and you are fearing for their life. Remember, no one knows your child better than you do. What is your intuition saying? 

Have as much conversation as you deem necessary to make a decision as important as this one.

It sounds obvious, but talk to your child. We were terrible at this. Wait, if you can, until everyone is calmer. Likely, you’ll have to do this (or start it) in a therapeutic setting.

From the vantage point of now, I can’t say whether having dialogue with our mentally ill fourteen year old would have changed much about what happened, but that’s the point. I don’t know. We didn’t give ourselves or her the chance to truly process or query what was about to happen.  

I’ve said it before and I’ll say it again. Engaging in self-care is crucial because it will help you maintain your own well-being, reduce stress, and ensure you are in a healthier frame of mind. If we aren’t calm, our kids won’t be calm. (Yes, I know that our calmness doesn’t ensure theirs.) If you are in the process of making this decision or fear you might need to, seek professional help if at all possible. Placement in residential treatment can have far-reaching effects on the person we love and ourselves. Doing everything in our power to ensure a healthy outcome can go a distance to assuaging guilt and shame.

If you’re looking for a way to support your self-care practice, remember that engaging in self-care isn’t just about rest. It’s also about intentionally fostering creativity, building meaningful connections, and prioritizing mental wellness, all of which are central to what I call the “TYC Toolkit” approach to living a more authentic, balanced life.

Lastly, about regret. Regret is a terrible feeling, especially when we feel it in connection with a person we love most in the world. There’s just no way around the fact that the decisions we made on our journey to recovery had consequences: most acutely for our daughter–consequences that required more work and more healing and more forgiveness.

After a dozen years, much therapy, and many, many conversations, I can say that I don’t spend much time anymore feeling regretful. I’ve learned how to accept past decisions as part of my growth, our family’s growth. I focus on the present moment. By embracing self-compassion and understanding, I continue to foster my resilience and my development. I nurture my relationship with myself and with those I love.   

As always, I’m available for questions regarding this information or any part of our recovery journey. You can contact me here.