Hi J,
Dylan just completed an Residential Treatment Facility (RTF) stay this past year. We put him in on Sept 15 of 2007, and he was discharged on May 15 of 2008. It really wasn't much of a benefit for us either, and I'll copycat Linda on the "playground" theory.
We had our family sessions, of course, and Dylan had his individual therapy sessions. in my opinion, Residential Treatment Facility (RTF) works for a child when the child is willing, ready and able to work. If the child recognizes there are problems, and is hard core into working on those, Residential Treatment Facility (RTF) could probably be a benefit. When you have a child that isn't, it isn't.
Residential Treatment Facility (RTF) was a very structured environment, as Linda said. Dylan's day was broken up with therapies (riding horses - fun, horticultural therapy - fun, art therapy - fun) where he didn't really *work* on issues, but played. They focused very much on behavioral modification, family issues, where that isn't where the problems were. And, unfortunately, the people with Dylan the most, were not the people that were able to help him. The staff consisted mostly of college kids or young adults with no children, uneducated in true mental disability, and when the real issues arose, they had nowhere to go except to a therapist that handled 18 kids. And, until the issue got to her, Dylan had forgotten what, why and how to handle it.
My biggest gripe with the Residential Treatment Facility (RTF) was the schooling. They really did nothing in this regard. If Dylan acted up in school they shipped him right back to the residence, not dealing with the true issues at hand. And, when released, they just sent him right back to the same Emotional Support classroom he had faltered in previously, instead of looking at the true issues and trying to find the *best* placement for him. It's turned into more of a nightmare, actually - with the Residential Treatment Facility (RTF) giving him what he wanted (getting out of school, going back to the residence, not having to do the work in class), and within the first 2 weeks of school, he was hauled out.
They were kind enough to offer Wrap Around services to us, which is pretty much in home therapy with a person to do behavior modification with us. I declined it, because it's just not what we needed. And, actually - Dylan came home with so much anxiety and stress because of going from one very, very structured placement to home, that is was very hard to get him readjusted. He was having every other weekend visits, and toward discharge, more time here, but the transition was just hard. I don't know what would have helped him to make it easier.
I wish I had more to put in, but I don't. Our experiences with Residential Treatment Facility (RTF) haven't been good ones, and even the 3 B was in, they tended to work so hard on the family component, they weren't willing to see it wasn't a family issue, it was a difficult child issue.
I think Dylan's biggest issue going in was to learn coping skills. How to deal with anger, frustration, disappointment. Aside from throwing a stress ball at him, they didn't have the time or capacity to work with him as individually as I wanted or hoped they would, and he really got nothing out of it.