Newsletter #124 for Internationally Adopting Parents
February 11, 2010
PAL Center Inc.

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RESIDENTIAL PLACEMENT OF A CHILD

Residential placement of an internationally adopted child is typically the last resort for a family, extremely costly both emotionally and financially. At the BGCenter we've seen our fair share of desperate and often terrified families and kids that at their early age may be a danger to people around and often to themselves. What makes some residential institutions work (and some don't) and what does it entail to place your child into it? Two professionals Dr. Boris Gindis, chief psychologist at the BGCenter (tel. 845-694-8496) and Rhonda Jarema, Director of Family Support Services at Nightlight Christian Adoptions (4430 E. Miraloma Ave, Suite B, Anaheim Hills, CA 92807; tel 714-693-5437) talk about their experiences with residential placements.

B. Gindis:

In the past our patients had success with a number of residential institutions like Ranch For Kids Project (www.ranchforkids.org), Green Chimneys (www.greenchimneys.org), The Learning Clinic (www.thelearningclinic.org) and Pathways Academy (www.mghmclean.org). So, what makes a residential placement work? And is their experience transferable to the family setting? Several things come to mind, for example, talking about the Ranch for Kids:

Each of these institutions is a community in and of itself, providing consistent care, messages and rules for the kids.

The residential life is structured and based on the clear and necessary regulations and unavoidable "natural consequences" (expected rewards and punishments). The staff is direct and straightforward about behaviors - good and bad.

There is a lot of physical, outdoor activity that is healthy, mentally and physically, for the kids. In many cases kids work with the animals.

Chores are expected and when finished, help build self-esteem with the children.

Simple way of life, minimal choices and temptations, peer group influence projected by those who had already conformed to the rules of the institution - all these factors are powerful therapeutic means, not available in most families.

A residential institution is a new and temporary setting for a child, with its own unique group dynamic, and every child who arrives there gets a fresh start.

The staff does not require love, just respect and following the rules. This is a great difference, and emotionally traumatized children, being afraid of intimacy and unable to express their emotions in the way expected by their adoptive parents, may feel much easier and safer emotionally there.

There's probably a lot more, but this is what comes to mind when thinking about the successful residential facilities. The question is - how many of these characteristics could be transformed into a family setting? Unfortunately, not many and for various reasons. A family may probably replicate a specific rule, method, parental technique, but not the entire unique environment, thus its effectiveness may not be transferable. This is why we have an explosion of residential treatment centers for children.

R. Jarema:
Usually for residential treatment placement, insurance requires several prior psychiatric hospitalizations. If there is a history of behaviors, requiring several psychiatric hospitalizations, insurance might cover a short term (3-6 month program). I would encourage you to contact your insurance and ask about their perimeters for residential treatment. Most insurance companies will not cover more than 3 months of residential care and they usually require a weekly justification of continued residential placement. Residential care generally costs several thousand dollars monthly.

Generally for longer term residential treatment care, your school district and the county mental health programs need to be involved and determine that your child requires that level of supervised care. It is very difficult to get insurance and or the county/school programs to cover residential care unless lower levels of care have been attempted and have not been successful. This would include a supervised setting in the high school (some schools have behavioral health components -- generally meeting with the school district psychologist a few times a month and perhaps a self-study type classroom) or a partial hospitalization program. It is unusual for these programs to pay for residential until you can show that these alternatives have been tried first. There are exceptions, but they are very few. Residential placement is very expensive. There are also many types of programs. I'd encourage anyone interested in this type of program to do a lot of research on the Internet and go visit programs within a few hours of your house. You should be able to get a list of local facilities (within a few hours of your home) by contacting local adolescent psychiatric units, university hospitals, your local mental health office and even the school psychologist.

I doubt your school will offer the resources without your asking for them specifically, but they will probably provide them if you ask. These placements come out of their budgets and in this time of budget crunches, they do not want to pay for residential treatment for children unless they believe the child would endanger other children in the school. In addition, if you find a program that you are interested in, do ask them how to access services for your child. They can be very helpful. If they are not helpful, that too will tell you something about their program. I would also ask if there are any parents whose kids are in the program or recently graduated, who might be willing to speak with you. You will learn more about the program from other parents, than you might just checking it out yourself.

An excellent resource for families who have children with mental health issues, is NAMI -- National Alliance on Mental Illness (www.nami.org). This is a support organization for both individuals with mental health issues and their families. They have support networks throughout the country. In addition, they have an educational class for parents that is excellent. They have branches in every State.

B. Gindis:
Yes, the fees for these residential facilities are extremely high, and the school districts typically are not looking forward to pay them. But with the help of an experienced lawyer and a really good psychological report that can show the need and eligibility for such residential placement, it's doable. A number of my patients were granted the approval for this kind of placement and benefited greatly from it.

 

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