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please help, need advice, I work in a Residential Treatment Center (RTC).....
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<blockquote data-quote="slsh" data-source="post: 403649" data-attributes="member: 8"><p>Hi Raybaro - the key thing I noted in the 2 excellent RTCs my son was in was the rigid scheduling and control of the environment. Not to say it didn't occasionally get chaotic, but... that's the nature of where you're working, you know? Consistency and detachment are also key. Good staffing is also important. In my son's first Residential Treatment Center (RTC), from age 9-12, he was in a unit of 10 kids and there were always 4 staff members on the unit during waking hours. The Residential Treatment Center (RTC) also had roaming staff available for crises. </p><p></p><p>It's really hard to address restraints broadly. The underlying reason for restraints is going to vary by kid. Obviously (hopefully), you are only restraining kids who are engaging in dangerous behavior, you receive frequent training in CPI, and the treatment team for each kid is aware of the frequency of restraints and is addressing this in the treatment plan. </p><p></p><p>For my son, he thrived on restraints, actually sought them out. It gave him control of the situation (in his distorted thinking) and he got the undivided attention of several staff members. Knowing this didn't really help the treatment team come up with- new solutions for deescalating him because he would simply up the ante until a restraint was the only choice left. I'm not sure what finally broke the cycle at age 15 - at that point he was in a facility that used chemical restraints (last resort, not something I was real happy about, but he was 6', 200 pounds, and was getting physically restrained multiple times a day, at risk not only to himself but also to staff). I don't know if he finally matured and "got it" or if it was his loss of control of the situation when they chemically restrained him - I suspect a combination of both. </p><p></p><p>The keys to a good Residential Treatment Center (RTC) in my book are structure, structure, structure, well-trained staff with- good supports from admin and ancillary staff, and more structure. If you're walking onto a unit that has not been run well, you're going to have to expect out of control behaviors from the kids that will probably get worse before it gets better as you implement structure and routine.</p><p></p><p>You also need to remember who your clients are. They are not there because they can comply with rules, control their behaviors, and follow instructions. Your job is to help them learn self-control while addressing the underlying issues and at the same time keep them safe from themselves and their peers, while also keeping yourself safe. Unit staff are in the trenches - you're dealing with behaviors that we could not manage at home. It's an incredibly difficult job.</p></blockquote><p></p>
[QUOTE="slsh, post: 403649, member: 8"] Hi Raybaro - the key thing I noted in the 2 excellent RTCs my son was in was the rigid scheduling and control of the environment. Not to say it didn't occasionally get chaotic, but... that's the nature of where you're working, you know? Consistency and detachment are also key. Good staffing is also important. In my son's first Residential Treatment Center (RTC), from age 9-12, he was in a unit of 10 kids and there were always 4 staff members on the unit during waking hours. The Residential Treatment Center (RTC) also had roaming staff available for crises. It's really hard to address restraints broadly. The underlying reason for restraints is going to vary by kid. Obviously (hopefully), you are only restraining kids who are engaging in dangerous behavior, you receive frequent training in CPI, and the treatment team for each kid is aware of the frequency of restraints and is addressing this in the treatment plan. For my son, he thrived on restraints, actually sought them out. It gave him control of the situation (in his distorted thinking) and he got the undivided attention of several staff members. Knowing this didn't really help the treatment team come up with- new solutions for deescalating him because he would simply up the ante until a restraint was the only choice left. I'm not sure what finally broke the cycle at age 15 - at that point he was in a facility that used chemical restraints (last resort, not something I was real happy about, but he was 6', 200 pounds, and was getting physically restrained multiple times a day, at risk not only to himself but also to staff). I don't know if he finally matured and "got it" or if it was his loss of control of the situation when they chemically restrained him - I suspect a combination of both. The keys to a good Residential Treatment Center (RTC) in my book are structure, structure, structure, well-trained staff with- good supports from admin and ancillary staff, and more structure. If you're walking onto a unit that has not been run well, you're going to have to expect out of control behaviors from the kids that will probably get worse before it gets better as you implement structure and routine. You also need to remember who your clients are. They are not there because they can comply with rules, control their behaviors, and follow instructions. Your job is to help them learn self-control while addressing the underlying issues and at the same time keep them safe from themselves and their peers, while also keeping yourself safe. Unit staff are in the trenches - you're dealing with behaviors that we could not manage at home. It's an incredibly difficult job. [/QUOTE]
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