Outcomes in Children's Residential Treatment Centers: A National Survey 2010

Abstract

In 2010 the Research Committee for the American Association of Children's Residential Centers (AACRC) embarked upon a project to repeat the survey that was originally sent out in 1999, hoping to learn how agencies have adapted as well as what was new in the residential treatment environment. The committee was interested in population changes, length of stay, diagnosis, gender, and race, and whether there had been changes in sources of funding and services funded. The committee was particularly interested in the role of data collection and analysis, and how agencies use data to improve process and evaluate outcomes. The growth and sustainability of residential treatment as a viable service option may depend upon the field's willingness to track results, partner with families and the youth they serve, and to make themselves accountable to all stakeholders in the children's services system.

Keywords:

• survey
• residential treatment
• data collection
• outcomes
• research

Notes

Thanks to the AACRC member agencies and individuals who provided support and countless hours of work for this project.

1. One potential issue this survey does not uncover is that clients may have been private placements that were paid for with both private funds as well as the family's private insurance. In the 2010 survey we asked, “What percentage of your population is referred by,” as well as, “What percentage of your total RTC bed revenue is from,” as two separate questions, which they most definitely are. The answers to both questions correlate within a few percentage points of one another. The analysis of the 1999 survey seems to have combined these two questions into one, neglecting to ask about revenue that came from fund-raising.

2. There were differences in terminology between the 2010 survey and the 1999 survey. In some cases the meaning of the terms may not correlate perfectly. We paired them as follows:

3. Standardized instruments used by only one program: ABAS, ABAS-II, ABLLS-R, ACE Trauma Assessment, ADAS-R, ADI-R, ADOS, ADOS, Adult/Adolescent Parenting, Aggression, Questionaire, Alabama Parenting Questionnaire (APQ), BASC, BRIEF, CFIT–Vanderbilt University, CHQ PF-28, CRAFFT, Devereux Scale, Family Assessment Screening Inventory, GADS, HIT, Hopelessness scale, “How I think” Questionnaire, JRI Core Battery (11 measures), Juvenile Sex Offender Assessment Protocol - II (JSOAP-II), Kaufman KTEA Academic Achievement, LCEI, PIAT-R, PIKOC, POSIT (AOD), SCQ, Sensory Profiles, Skill Streaming, Strengths and Difficulties Questionnaire (SDQ), TRAUMA SYMPTOM CHECKLIST, UCLA Trauma Assessment, UCLA-PTSD Index, WAIS-IV YOUNG MANIA RATING SCALE.

4. Because different agencies were surveyed in 1999 and 2010, changes in data may reflect different practices between different agencies as opposed to changes in the same agencies over time.

5. Although there was a substantial response to the surveys, this was neither a random sample nor a national sample, and generalizations from the findings should take this into account. In addition, while a number of agencies participated in both the 1999 and 2010 surveys, there were many that only participated in one or the other, and changes in data over time may reflect different practices between different agencies as opposed to changes in the overall residential care landscape. Despite these caveats, our confidence in the generalizability of the survey findings is bolstered by the degree to which they accord with national policy trends.