The Shutdown: Crisis Management in Residential Treatment

ABSTRACT

On occasion, residential treatment centers for adolescents with severe psychiatric problems may encounter crises that engulf the program as a whole. Standard techniques for addressing serious acting out in problematic patients no longer seem effective; peers collude in sustaining each others’ problems; relationships among and between staff and patients deteriorate sharply; and the capacity of the residence to serve as a vehicle for treatment is compromised. This article describes a technique for managing such crises, the unit shutdown. It explores the causes of shutdowns, the treatment process during them, their rationale, and the functions they serve.

KEYWORDS:

• adolescents
• crisis management
• residential treatment

Acknowledgments

The author is indebted to Babette Curry, James Kleiger, PhD, and Maria Luisa Leichtman, PhD, for reviewing this article and for their insights into the residential treatment process.