5 Alternatives to Residential Treatment

alternatives to rtc
When families are at the end of their rope, out-of-home, residential treatment seems to be the default next step. This post is in no way meant to pass judgment on or create guilt around residential treatment. We’ve faced firsthand the desire to just have our child stop creating havoc in our lives. Unfortunately, we’ve found that being at the end of your rope is a lot like being stuck on a dead end, one-way street. You can’t return from whence you came, but there also no visible next turns. For two engineers whose profession is to solve problems, this space can be terrifying or it can be the next new challenge. It’s been both for us. Terrifying usually comes first, but once we can wrap our thinking brain back over our lizard brain, the wheels start turning.

The problem:

There is a kid in our home who is creating an unsafe environment, either physically or emotionally.

Possible solution #1-Residential Treatment:

Simply carting said kid off to residential treatment could reinforce the insecurity that is causing the breech in safety to begin with. Additionally, there are almost no treatment facilities that use Trust-based Relational Intervention (TBRI), and, if there were, we couldn’t afford them anyway.

Possible solution #2-Respite:

While you may get respite, it’s really only like a timeout in life. There’s no plan for healing or improvement on the other side. In fact, the re-entry fallout could make this option not feel worth it at all. I do believe respite has its time and place, but it’s also so temporary.

Possible solution #3-Disruption:

The opposite of temporary, this would be like creating a death in our family. While there are some problems it would solve, we’d be creating a wake of grief and more broken relationships and trauma. Again, I’m not judging those who need to go there, but we didn’t want to stop at this solution.

Moving on…

Possible solution #4-Create an in-home residential treatment:

If there are known triggers to a season of unbearable behavior, and you’re working with a great therapist who you can get on board, this may be a viable option for your family. For this option, you would remove as many distractions as possible (including other kiddos in the house) for a week or two and get extra time with the therapist. Yes, we were able to find alternative housing for the other 5 kids for a week because when you’re desperate, you’ll do almost anything, casting normal social inhibitions aside. In our case, we didn’t get extra therapy time, but the removal of distractions gave me emotional space to be the best therapeutic parent I could be and focus on increasing our child’s felt safety for a full week. Unfortunately, we just found that our child was reactionary with me no matter how many other kids were home, so it was not our golden ticket like we hoped. However, that doesn’t mean that it won’t be successful for your family. Side benefit: The other kids got a break from our household trauma.

Possible solution #5-Remove the child from your home, but have a parent go with:

We’ve actually resorted to this a couple times now. The first time was kind of dramatic and took our child far outside of the comforts of familiarity. It worked like respite but had less fallout because there was still a parent with her so her abandonment issues weren’t triggered. The second time was a bit more thought out, but also much longer term. We pitched it to her as a treat to be able to spend uninterrupted time with mom. However, the practical reality was that the rest of the family is getting a much needed break. Did you catch the switch to present tense? Yes, we’re in the middle of trying this solution again. This second time is also paired with an increase in EMDR therapy designed to decrease the triggers that are causing her to lash out at our household members with the hopes that reintegration can occur in a couple months.

The last two solutions were designed to create peace and safety for our family while still creating felt safety for the hard kid. Many have asked us, “What happens at the end of summer?” Honestly, we’re not thinking that far ahead because the landscape of trauma changes moment-by-moment. We do have a couple other ideas up our sleeves in a plan for the worst, hope for the best mentality.

What tricks do you have up your sleeve that might help a family who wants to avoid residential treatment?

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