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
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
In the past our patients had success with a number of
residential institutions like Ranch
For Kids Project
(www.thelearningclinic.org) and Pathways
(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:
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.
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
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.
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.