STRTP and QRTP facilities, while still making a difference in youths’ lives, face critical challenges. Whether an organization has an STRTP (Short-Term Residential Therapeutic Program) in California or QRTP (Qualified Residential Treatment Program) throughout the country, the task of stabilizing a youth’s functioning is not getting any easier. In some cases, the work is becoming so difficult that more of these facilities are closing.
The treatment and guidelines are part of the Families First Preservation and Services Act designed to keep youths closer to their homes. Youths sent to these facilities display difficulty in traditional home environments such as with their family or in a foster family setting. 24-hour care, therapy, and programs are designed to help them improve their functioning. What are the challenges facing these agencies?
The higher acuity of youths. The youths now entering these facilities have more longstanding emotional and behavioral problems. Substance use, commercial sexual exploitation, fire setting, sexual offenses, runaways, and gang involvement are typical among the youths. The STRTP and QRTP having youths with more complex problems together can lead to increased dysfunction. For example, if one youth is heavily involved in sex trafficking for her “pimp”, she can encourage her housemates to join her. If they also have a history of sex trafficking, the group environment may embolden more to run away rather than less.
Reduced use of mental health services. The STRTP and QRTP may be required to hire mental health staff to provide onsite mental health services for the youths to help them with therapy, behavioral interventions, or other skills. Yet the staff can only bill for services the youth attends. If youths don’t want to go to therapy, they can’t be forced. Subsequently, the staff cannot bill, and the agency cannot receive compensation for the staff salaries. As a result, there is reduced use of the mental health services, and agencies lose money with staff who cannot treat youths unwilling to receive care.
Staff turnover. Traditionally, STRTPs and QRTPs have a 50% turnover rate of staff yearly. But with the higher level of youth behavioral challenges, together with COVID, many staff don’t want to work in these facilities anymore. Secondary trauma, together with dissatisfaction with documentation and regulatory demands makes it more challenging for agencies to hire and retain staff.
To meet these challenges, organizations will require more training, better policies and procedures, better hiring practices, and a different philosophy about the youths and their care. Therapy techniques need to be modified to meet the youth where they are at, walking a mile in their moccasins. Use of Motivational Interviewing, harm reduction, and behavioral strategies such as Functional Behavior Analysis are skills staff will need. The trauma-informed approach to youths and stress management skills are at the core and make significant differences in improving functioning. While STRTPs and QRTPs will continue to face uncertain futures, modifying programs to meet youth and regulatory needs keeps them at the forefront of residential care.
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PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
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