Abstract
This paper addresses the need for a coherent conceptual therapeutic approach to guide work with disturbed children and adolescents in residential treatment centers. The paper identifies changes in the population currently in care; examines the two dominant approaches that historically have shaped the standard treatment models used by most residential centers; and discusses four longstanding debates that have complicated the development of a consistent therapeutic approach for residential programs. It concludes with a description of The Sanctuary® Model. Integrating a variety of treatment approaches, this trauma-based systems approach to care was first used with adult inpatients traumatized as children. It is now being introduced by a major social agency into three of its residential centers to provide a systematic treatment model for use in their schools, living units, and treatment sessions.
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REFERENCES
Burns B, Hoagwood K, Mrazek P: Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review 2(4):199-254, 1998.
Bloom SL: Creating Sanctuary: Toward the Evolution of Sane Societies. New York, Routledge, 1997.
Guterman NB, Cameron M: The Odyssey Project individual agency report, in Unpublished paper. New York, 1999.
Small R, Kennedy K, Bender B: Critical issues for practice in residential treatment: The view from within. American Journal of Orthopsychiatry 61(3):327-337, 1991.
Wells, W., Wells K., Whittington D., Characteristics of Youths Referred to Residential Treatment: Implications for Program Design, manuscript submitted for publisher 1991.
Wolfe D: Child Abuse. Newbury Park, CA, Sage, 1987.
Cicchetti D, Carlson V: Child Maltreatment: Theory and Research on the Causes and Consequences of Child Abuse and Neglect. New York, Cambridge University Press, 1989.
Van der Kolk B, Fisler R: Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress 8:505-525, 1995.
Zimmerman PD, Cohler BJ: From disciplinary control to benign milieu in children's residential treatment. Therapeutic Communities 19(2):123-145, 1998.
Aichorn A: Wayward Youth. New York, Viking, 1939.
Bettelheim B, Sanders J: Milieu Therapy: The Orthogenic School Model, in Handbook of Child Psychiatry, Vol 2, 1979.
Kennard D: An Introduction to Therapeutic Communities. London, Jessica Kingsley, 1998.
Bridgeland M: Pioneer Work with Maladjusted Children: A Study of the Development of Therapeutic Education. London, Staples Press, 1971.
Hoffman L, Singer PR: The incompatability of the medical model and the therapeutic community. Social Science and Medicine 11:425-431, 1977.
Fees C: "No foundation all the way down the line": History, memory and 'milieu therapy' from the view of a specialist archive in Britain. Therapeutic Communities 19(2):167-178, 1998.
Rothman DJ: The Discovery of the Asylum: Social Order and Disorder in the New Republic. Boston, Little, Brown and Company, 1990.
Brace CL: The Dangerous Classes of New York, and Twenty Years' work Among Them. New York: Wynkoop and Hallenbeck 1872.
Ehrenreich JH: The Altruistic Imagination: A History of Social Work and Social Policy in the United States. Ithaca, NY, Cornell University Press, 1985.
Lubove R: The Professional Altruist: The Emergence of Social Work as a Career 1880-1930. Cambridge, MA, Harvard University Press, 1965.
Wells K: Long-term residential treatment for Children: Introduction. American Journal of Orthopsychiatry 61(3):324, 1991.
Bloom SL: The Sanctuary Model: Developing generic inpatient programs for the treatment of psychological trauma, in Handbook of Post-Traumatic Therapy, A Practical Guide to Intervention, Treatment, and Research. Edited by Williams MB, Sommer JF. Westport, CT, Greenwood Publishing, 1994.
Bloom SL: Creating Sanctuary: Healing from systematic abuses of power. Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations 21(2):67-91, 2000.
Nagler MN: Is There No Other Way? The Search for a Nonviolent Future. Berkeley, CA, Berkeley Hills Books, 2001.
Senge P: The Fifth Discipline: The Art and Practice of the Learning Organization. New York, Doubleday, 1990.
Goldstein J: The Unshackled Organization. Portland, OR, Productivity Press, 1994.
Foderaro J: Creating a nonviolent environment: Keeping Sanctuary safe, in Violence: A Public Health Menace and a Public Health Approach. Edited by Bloom S. London, Karnac Books, 2001.
Foderaro J, Ryan R: SAGE: Mapping the course of recovery. Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations 21(2, Special issue):93-104, 2000.
Jones M: Beyond the Therapeutic Community: Social Learning and Social Psychiatry. New Haven, CT, Yale University Press, 1968.
Rivard JC, Bloom SL, Abramovitz RA, et al: Assessing the implementation and effects of a trauma-focused intervention for youths in residential treatment. Psychiatric Quarterly 74(2):137-154, 2003.
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Abramovitz, R., Bloom, S.L. Creating Sanctuary in Residential Treatment for Youth: From the “Well-Ordered Asylum” to a “Living-Learning Environment”. Psychiatr Q 74, 119–135 (2003). https://doi.org/10.1023/A:1021303710275
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DOI: https://doi.org/10.1023/A:1021303710275