Variation in Evidence-Based Practices Among Youth-Serving Residential Treatment Facilities

Abstract

Background:

Residential treatment is among the most intensive and expensive settings for children with behavioral health challenges; yet, the extent to which evidence-based practices are used in these settings is unknown.

Aim:

The purpose of this study was to describe the extent which family therapy, case management, telehealth, peer support, and family psychoeducation are provided in residential treatment using data from the National Mental Health Services Survey (N-MHSS). Organizational factors—region, ownership, payment, licensing/accreditation, and facility size—were examined in relation to evidence-based practices to understand disparities in care.

Methods:

This was a secondary analysis of publicly available data from the 2018 N-MHSS. A subpopulation was created consisting of residential facilities that served children (N = 576). Descriptive statistics were used to describe the sample, and Cohen’s h was calculated to determine patterns of evidence-based practice utilization.

Results:

Evidence-based practices from most to least prevalent were family therapy (76%), family psychoeducation (74%), case management (71.1%), telehealth (17.2%), and peer support (8.7%). The provision of evidence-based practices was not evenly distributed. There were primarily small to moderate differences by organizational factors, including region (i.e., Northeast, Midwest), ownership status (i.e., for-profit), payment type (i.e., self-pay, private insurance), licensing/accreditation (Department of Family and Children Services), and facility capacity (>251 clients served per year).

Conclusion:

Findings demonstrate a need for research-practice partnerships to determine the barriers that prevent effective evidence-based practices from being implemented in the residential treatment setting.