Here is the step-by-step, detailed explanation of how we got our son into residential treatment and how it was funded.
- Early Childhood Trauma
- Home with Us
- Fear, Loss, & the Reunification Goal
- Adoption: Forever Family But Still Broken
- Extreme Behaviors
- Seeking Treatment
- Life in Crisis
- Cries for Help
- Surviving, But Not Really Living
- Closed Doors
- At the End of Our Rope
- Falsely Accusations
- A New State & New Hope
- Getting Into Residential Treatment
- Funding Residential Treatment
- When Your Child Goes to Residential Treatment
- Treatment Progress
- What A "Happy Ending" Looks Like
Does your child or teen need residential treatment for mental health issues or behavior problems? If you are wondering how the process works, read on for our story, and guidance for how to secure a place for your child in a facility to help them be safe and find healing.
Note: To protect my child’s privacy, I did not share his name or identity, but the story you are about to read is 100% true. This is our family’s experience.
Early Childhood Trauma
Our son came to us as a foster child at 5 months old. He was a micro-preemie, born at just 25 weeks of gestation. He almost died several times during his first weeks of life, and his twin brother died of complications from prematurity when he was two months old.
After 3 months of care in the Neonatal Intensive Care Unit (NICU), which included Heart surgery, feeding difficulties, and many complications, our son was allowed to go home with his birth mother.
Our son’s first mother was only 16 years old, and the staff was concerned about her ability to care for any child, let alone a tiny baby still on oxygen, facing additional surgeries, and needing a tremendous amount of around-the-clock care. Although the Department of Human Services was involved, they allowed her take the baby home.
After just a few weeks at home, his birth mother brought him to the emergency room for difficulty breathing. There, they discovered that in addition to having pneumonia, he had many broken ribs in various stages of healing, and a broken leg that had healed on its own.
The baby was placed in foster care, and soon he would be coming to our home.
Home with Us
We had older biological children and several years of foster parenting under our belts when we received the call for the little boy who would one day be our son.
I never hardened myself to the realities of what our foster children experienced before they came to us. I cried when the worker called with the news that he had a placement for a 5-month-old baby, on oxygen, with multiple broken bones.
After talking it over with my husband and kids, we knew the answer could only be a yes. We would bring this little one into our home.
My husband and I went to pick him up from the hospital, where he was wrapped in a tight swaddle. An adorable little guy with a dark brown skin and a head of thick, straight hair, he had a near-constant anxious crease between his eyes. I had never seen such a worried frown on a baby.
The next day, I took him to our pediatrician for an intake check-up. She and I both had tears in our eyes as we reviewed the charts with his medical history. He was so tiny to have already experienced multiple traumas.
We jumped into the tasks of caring for a medically fragile baby who needed so much care and attention. Our home was soon busy with therapists and social workers coming to evaluate his needs.
Fear, Loss, & the Reunification Goal
Our son began supervised visits with his family, and a goal was set for reunification.
Family reunification is a lofty goal. The sad truth is that while birth parents work to better themselves, their children live in a state of confusion. This confusion leads to loss of identity and struggles with attachment that can eventually lead to attachment problems or Reactive Attachment Disorder (RAD).
While he couldn’t articulate it, I know our son was feeling the loss and upheaval:
- Who is the parent?
- Who do I trust?
- When will things become “normal?
The longer he was in our home, the more we bonded to this precious little boy. While we continued to support his birth family, we knew that if he became available for adoption, we wanted him in our family as our child.
Adoption: Forever Family But Still Broken
When he was two years old, a judge ruled to terminate parental rights for our son’s biological parents, and we adopted him when he was two and a half. This was an amazing day, and we officially became a family together.
We thew a huge party and celebrated this milestone for our entire family.
We expected (and willingly signed on for) a lifetime of medical issues. Amazingly, our son grew to be physically strong and able-bodied.
Yet, adoption does not fix the deep wounds of early childhood trauma.
As our son grew into a toddler and then a little boy, we realized our greatest challenges lay ahead.
Our son grew, and we noticed behaviors that were extreme, difficult and even outright bizarre. As experienced parents, we knew something was off, but we didn’t understand the full implications.
We had managed hyperactive children before, but this child’s behavior was extreme.
- When I took him to the doctor, he was literally bouncing off the walls in the small appointment room.
- Far beyond typical toddler temper tantrums, our son raged. These rages lasted for hours, when he would hit, spit on, kick, head butt, and bite us. He was out to inflict pain, and he often succeeded.
- He destroyed his room, the walls, and furniture.
- He ruined toys, often just hours after receiving them.
- He was obsessed with trinkets, collecting and hoarding unusual items like dirty playground turf, paperclips, and wood nails.
- He seemed to have no sense of self, blending in and going along with anything his friends said or were doing.
- He spoke in non-sensical ways, talking constantly, asking endless questions, and demanding attention.
- He was superficially charming, getting treats, rewards, gifts, fast food meals, trinkets, and praise from teachers, bus drivers, people at church, and strangers. No matter how often we told people not to give him these items, it was as if adults couldn’t resist his charms.
- He cried endlessly over inconsequential things (a tiny cut, a small change in schedule) yet seemed completely oblivious to true physical hurts or things that would bother other kids.
- He was loving and engaged – on his terms and when he wanted his way.
- We walked on eggshells, waiting for the next rage, blow-up, or school suspension.
- Our lives began to revolve around his needs, rages, and problems, often in unhealthy ways.
By the time he was in elementary school, we were getting almost daily calls from the principal. He was often suspended for fights, bullying, swearing, destroying school property, and stealing.
At home, things were even worse, where we got to the point that we were calling the police because we couldn’t handle his dangerous, physically aggressive rages.
There was rarely a time that our son wasn’t in some type of treatment. We started with physical, occupational therapy, and feeding therapy. As his physical challenges improved and his behaviors increased, we worked with therapists to manage his mental health.
We started at the local mental health clinic, which is what his Medicaid (given as part of his adoption subsidy) allowed. We soon learned that these inexperienced therapists were causing us more harm than good.
We didn’t comprehend it at the time, but our son’s behavior was directly connected to early childhood trauma and disorganized, anxious attachment. Typical mental health therapy or play therapy seeks to build trust and connection between the therapist and client.
Attachment therapy must take non-standard approach. Because the bonds of trust have been severed, children with attachment issues will not trust the therapist. Instead, they will attempt to charm, manipulate, and triangulate the adults involved.
We began reading books by Nancy Thomas and Bryan Post, which explained the needs of children with attachment problems. While this gave us a greater understanding of our son’s needs, we still didn’t have the practical strategies to deal with his extreme behaviors that were now threatening to tear our family apart.
Life in Crisis
When he started middle school, our son was moved to a small school for children with behavior needs. We were relieved that he was in a educational situation where he behavior problems were better tolerated, yet we were also concerned about the environment.
Walking into the school, kids were often screaming, raging, and swearing. Our son and other students were restrained almost daily. This environment was creating new, daily trauma on top of the PTSD our son already had.
Around this time, we son was taken to the emergency room for the first time for mental health reasons. The first time, the ER staff was supportive and he was placed into a behavioral, short-term inpatient unit for about a week. His medications were adjusted, and he was sent home.
This began a years-long cycle of taking him to the ER, his medication being increased, and then him being sent home, with no real improvements occurring.
We knew that calling 911 or taking him to the ER didn’t bring positive results, but we also felt desperate and stuck. As he was getting older, his rages became increasingly intense and violent. We feared for our safety, our son’s safety, and the safety of our other children.
Cries for Help
The tipping point came when we found out that our son had repeatedly harmed one of the younger children in our home. We were devastated to discover that this sibling-on-sibling abuse had occurred “on our watch”.
We spiraled into parental guilt, horror, and anger.
We immediately began intensive line-of-sight supervision. We kept doors locked and installed video cameras. We installed door alarms on the kid’s bedroom doors. We made sure an adult was present and in charge for every awake moment of the day.
Yet even with these measures, we knew we could not keep the children in our home safe.
The time had come to take direct action. I’ll never forget the day I made a phone call to the Department of Human Services (DHS) to “turn myself in” and say that I could no longer keep my son in our home. I explained the details to the person from DHS who took the call.
She said that someone would contact us right away with next steps.
My husband came home early from work, and we clung to each other, in tears. We had no idea what would happen next, but we were sure someone from DHS would show up on our doorstep at any moment to take our son into their custody.
Imagine our shock when…nothing happened.
Exhausted and depleted, we headed to bed that night, sure that someone would contact us the next day.
Yet again…nothing happened.
Over a week later, we received a phone call from a DHS worker who wanted to schedule a quick check-in visit in a few weeks.
Wasn’t anyone concerned about the abuse that our son had inflicted on other children in our home?
For years, we had discussed the possibility that our son would need residential treatment. The time had come. We couldn’t safely parent him anymore.
We still needed to learn this important truth:
Just because your child needs residential treatment, doesn’t mean they will get residential treatment.Alyssa Carter, www.childresidentialtreatment.com
Surviving, But Not Really Living
We navigated through daily home life, barely surviving.
Our home felt less like a family and more like a quasi-treatment program. Simple tasks, like cooking a meal or sitting down to watch a family movie, were impossible.
We had multiple children who raged continually, destroyed properly, and sought to harm us. They reacted off of each other, a ricochet of unhealthy behaviors.
During this time, we tried everything we could think of to get our son into residential treatment.
- We called 911 so often, the operator finally told me we couldn’t keep calling.
- We called the police and filed police reports.
- We took our son to the ER for mental health evaluations – again and again.
- We called the Department of Human Services and begged for help.
- Our therapists advocated for us with the Department and Medicaid.
- We enrolled our son in day treatment.
- We did intensive in-home treatment with therapists who came into our house.
- We participated in a multi-systemic (MST) program.
- We participated in wrap-around services.
- When he was inpatient at the hospital, we refused to pick him up.
- At one point, my husband moved out of our home and in with his parents, with our son, because we felt we couldn’t supervise all the children safely in a home environment.
- We sought post-adoption services from every program we could find.
- We advocated for his care on the county and state level.
- We hired an educational advocate (and later, an attorney).
Always, through it all, we begged for help. We pleaded for assistance. We were told that our son’s behaviors weren’t bad enough, or that we had agreed to adopt him, so we had to figure it out.
We were told many times over, “You are such good parents. We know your kids are safe. You are doing all the right things.” While we appreciated the compliments, it didn’t do anything to help us get the treatment he needed.
At the End of Our Rope
We had come to the end of what would could emotionally manage.
- Our marriage suffered (and understandably so…we weren’t even living in the same house).
- Our other children spent so much time locking themselves in their rooms, we didn’t remember what it was like to have typical family time.
- My husband was criticized at work for under-performance.
- My mental health faltered.
- We lost friends.
Something had to change, yet we were turned away from every source of help.
On the brink of emotional breakdown, we contacted an attorney even though we couldn’t afford it. Debt or no debt, we had no choice.
The attorney specialized in these types of cases and had expertise in adoption law. He met with us, and we explained the situation.
He asked if we had considered TRP (Termination of Parental Rights), and we said no. We knew it was possible to rescind an adoption and place a child back into foster care, yet that had never been our desire.
We wanted to see our son get help, not leave our family. Our lawyer was pleasantly surprised and said that most parents he worked with were pursuing TPR. (I don’t fault adoptive parents who make the incredibly difficult choice to terminate an adoption. They are, like we were, at the end of their emotional rope. Because of a broken system, sometimes they are left with no other choice.)
A few weeks after we paid the retainer and signed an agreement with the attorney, our son raged to the point of being violent. He was transported to the emergency room by ambulance, and then placed in a short-term in-patient program.
When his time in the program ended, we made the incredibly difficult decision to refuse to pick him up.
The staff told us that they would call the Department of Human Services and report us. We said we understood.
They threatened us with a huge hospital bill since insurance wouldn’t pay for more days. We said we understood.
We were charged with child neglect.
The Department of Human Services opened a case against us. The department made threats against us in regard to our reputations, our jobs, and the security of the other children in our home.
The pressure to bring our son home was massive. Our older children were interviewed repeated. We were mocked, belittled, and patronized.
Our new attorney supported us. He assured us that the state could charge us with child neglect or abuse, but they would have no grounds for us to be convicted.
He warned us that the road we were about to walk would be incredibly painful, expensive, and long. He was right.
During this time, my husband had been pursing a different job, and when one became available, he decided to take it. The issue was that it was in another state. What would we do with our son and how would we move him?
On the day that the judge would have charged us with child neglect, our attorney announced our plan to move.
The judge was highly suspicious. They had dealt with multiple situations like ours where the parents moved out of state – secretly and in the middle of the night – leaving the child in the care of DHS and with no way to contact the parents.
We assured the court that wasn’t our intention, and after much persuasion from our attorney, the case against us was dropped with the understanding that we would take our son with us.
A New State & New Hope
Our hope was to move our son from an in-patient facility in one state, directly into a facility in another state. This didn’t happen, despite doing all we could to advocate for our son’s needs. Until he was a resident in the new state, he was refused care there.
Despite our concerns, our son moved with us and lived with us at home. We arranged in-home services, but it didn’t take long until his behaviors ramped up to where they were before the move.
Getting Into Residential Treatment
We did all we could to provide line-of-sight supervision of our children, including installing video cameras in most rooms of our new house. Yet we worried constantly that our son would hurt a younger child or pet.
A few months after we had been living in our new home, our daughter walked into a situation where my son was abusing a younger child in our home.
We immediately called the police, our caseworker for in-home services, and the Department of Human Services.
We were treated very differently in the new state compared to the previous state. DHS came to visit the next day. They agreed to move our son into a short-term facility and that he wasn’t safe to be at home.
The court system became involved and charged our son (who was 12 years old at the time) with a crime, and the court system placed our son into residential treatment.
Funding Residential Treatment
Because our son was placed into care by the court system, they took the burden of paying for his care. Our child was placed into foster care as part of this process. We did not lose our parental rights, but we did not have physical custody of him.
Medicaid (which he received as part of his adoption agreement) paid for the majority of his residential care.
We were taken to court for child support and our wages were garnished to pay for part of our child’s treatment. This was another layer of pain and humiliation, which we had been warned would probably happen.
When Your Child Goes to Residential Treatment
There’s an incredible mixture of emotions when your child is placed into residential treatment. No parent wants this, and the pain of separation is deep.
Yet we were so completely exhausted and depleted, that the step brought tremendous relief. Then we felt guilt for feeling relief.
Our son was placed in a treatment program about two hours away from our home. We visited weekly, although we were one of the few families who visited.
We took baby steps toward healing our family and taking care of ourselves. Self-care takes practice and intention, especially when you haven’t done it for so long. We all went to therapy to process the trauma we had experienced.
Our son was in the residential facility for one and half years, and then returned home to reunite with our family.
Many parents are surprised to learn that treatment in a program does not provide more therapy than in the community. In fact, many children receive more therapy while in the home.
Residential treatment is the best choice when the issue is safety. Parents simply cannot provide the type of supervision that a care program with 24/7 supervision and staff can provide.
Our son was in a good program, and we were blessed that he did make progress there. While we were scared to bring him back home, he was able to live with us again successfully.
What A “Happy Ending” Looks Like
Today, our son is an adult.
He was able to live with us at home until he completed high school and graduated.
We had many rocky times as a family, and still struggle with our relationship with him, but nothing like the earlier years. Now, when our son makes poor decisions, we feel bad for him and wish he would choose differently, but we don’t fix it for him.
We invite him into relationship with us – with firm boundaries in place. Sometimes he accepts that, and other times he does not.
Our son still has many challenges, but he is working toward becoming a successful adult. We trust that he will continue to grow and develop as God guides him.
What are your thoughts as you read our experience? Share in the comments below.