Behavior Modification Facilities

Behavior mod 3behavior modification facility (or youth residential program) is a residential educational and treatment institution enrolling adolescents who are perceived as displaying antisocial behavior, in an attempt to alter their conduct. As of 2008 there were about 650 nongovernmental, residential programs in the United States offering treatment services for adolescents.  Some similar institutions are operated as components of governmental education or correctional systems. Practices and service quality in such programs vary greatly.

The behavior modification methodologies used vary, however, a combination of positive and negative reinforcement is typically used.

Often these methods are delivered in a contingency management format such as a point system or level system.

Such methodology is found to be highly effective in the treatment of disruptive disorders.

Positive reinforcement mechanisms include points, rewards and signs of status, while punishment procedures may include time-outs, point deductions, reversal of status, prolonged stays at a facility, physical restraint, or even corporal punishment. Research shows that time out length is not a factor and suggestions were made to limit time out to five-minute durations. A newer approach uses graduated sanctions. Staff appears easily trained in behavioral intervention, and such training is maintained and does lead to improved consumer outcomes, as well as reduce turn over. More restrictive punishment procedures in general are less appealing to staff and administrators.

Behavioral programs are found to lessen the need for medication. Several studies have found that gains made in residential treatment programs are maintained from 1–5 years post discharge.

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Therapeutic boarding schools are boarding schools based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with emotional and behavioral problems, substance abuse problems, or learning difficulties.

Some schools are accredited as Residential treatment centers.

Behavioral residential treatment became so popular in the 1970s and 1980s that a journal was formed called “Behavioral residential Treatment”, which later changed its name to “Behavioral Intervention.”

Behavioral Intervention continues to be published today.

In the late 1960s behavior modification or practice referred to as applied behavior analysis began to move rapidly into residential treatment facilities. The goal was to redesign the behavioral architecture around delinquent teens to lessen chances of recidivism, and improve academics.

Harold Cohen and James Filipczak (1971) published a book hailing the successes of such programs in doubling learning rates and reducing recidivism.

This book even contained an introduction from the leading behaviorist at the time, B.F. Skinner hailing the achievements.

Independent analysis of multiple sites with thousands of adolescents found behavior modification to be more effective then treatment as usual, a therapeutic milieu, and as effective as more psychologically intense programs such as transactional analysis with better outcomes on behavioral measures; however, these authors found that behavior modification was more prone to leading to poor relationships with the clients.

Over time interest faded in Cohen’s CASE project.

Other studies found that improper supervision of staff in behavior modification facilities could lead to greater use of punishment procedures. In the U.S. residential treatment programs are all monitored at the state level and many are JACHO accredited. States vary in requirements to open such centers. Due to the absence of regulation of these programs by the federal government and because many are not subject to state licensing or monitoring, the Federal Trade Commission has issued a guide for parents considering such placement.

On foreign soil U.S. laws do not govern the care American teens receive in overseas behavior modification compounds.

Glossy brochures and Web pages tout the beautiful natural surroundings at the behavior modification facilities.

Blue skies, sparkling beaches, waterfalls and glacier-fed lakes adorn promotional material.  I have also read contracts that require parents to hold a program harmless for false advertising, for any medical complication caused by staff mistakes, for bites, sores, infections, slow-healing cuts, and for all illegal or criminal acts committed against their child by staff members outside the scope of their employment.

I don’t necessarily blame parents who send their children to behavior modification facilities. What happens often is that parents are desperate. They think their kids are really in trouble. They don’t know what to do.

The average stay for a teen in a behavior modification facility exceeds 14 months. Fees parents pay in advance range from $4,000  to $8,000. There is no question that these programs are expensive.

I don’t like coercive behavior modification techniques or their policy of isolating children from their families.

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