Girls Enhanced Residential Treatment Facility

Prior to the establishment of Residential Treatment Facilities (RTFs), children and adolescents that were in need of intensive psychiatric care were placed in state hospital facilities. Due to the elimination of state hospital beds, residential psychiatric services have become community-based. Perseus House and other providers have served this population through the development of RTFs. Due to the escalating behavioral and psychiatric needs of some of this population however, it has become necessary to place these adolescents in secure settings with minimal mental health treatment and/or costly out-of-state placements. Since traditional RTF structure may not meet the needs of some youth, an even more intensive mental health environment such as the Enhanced Residential Treatment Facility is necessary and cost effective.

The identified population to be served is females ages 13 to 19, who are in need of residential mental health services and require 24-hour supervision, but are not in need of acute hospital-based psychiatric inpatient admission. These individuals may have failed in prior levels of care including traditional RTF or may be directly placed in the Girls Enhanced RTF as referred by the County Interagency Team. This population has evidenced a history of psychiatric intervention that has proven unsuccessful and is indicative of a need for more intensive services.

These young women have typically experienced trauma and demonstrated an inability to regulate their emotional and cognitive world, which is unfortunately evidenced by prior failed treatment interventions. As a result, they have limited ability to master their interpersonal experiences. This lack of internal and external control has led to an ever inaccurate “perception of self” and, perhaps often, a perception of others as being qualitatively “different” from others. The ongoing perception of self, all too often reinforced by others, necessarily leads to schema maintenance behaviors. Stated more directly, “This is the way I am, and this is the way I will be.” While these maladaptive behaviors are not successful in day-to-day settings, they remain a comforting reminder to the young woman that this view of self and her hostile environment are accurate which impedes recovery.

This program intends to provide an intense and ever-present challenge to that perception. A major focus will be to address the trauma history and significant mental health needs of these adolescents. The intensity of the mental health treatment far exceeds what current RTFs are able to provide. In both approach and degree, an intensive staffing pattern will immerse each young woman in a new world experience toward the development of a new self/world view. This will be accomplished through an integrated program with a focus on treatment for seriously emotionally disturbed adolescent females. Trauma Focused Cognitive Behavioral Therapy in conjunction with weekly psychiatric time will be a cornerstone of the therapeutic process. This program will also serve as a constant reminder of their need to connect to their broader community in ways that reinforce those positive qualities, and will discourage attention paid to chronic inaccurate views of self. This treatment approach will provide the adolescent with small group and one-on-one opportunities to engage in therapy to process daily experiences that will lead to more adaptive thoughts, feelings and behavior.