Foreword
Introduction
Chapter One MILIEU THERAPY
Evolution of Residential Treatment Centers
Defining Therapy in Children’s Residential Work
Basic Milieu Musts
Establishing Safety, Security, and Trust in the Milieu
The Importance of Physically Organized and Structured Environments
Unconditional Belief of One Adult
The Chance to Promote Change
Chapter Two ROLES
Hierarchies and Internal Communication
Defining Staff Member Roles in Residential Programs
Residential Program Types
Aftercare Services
Keeping Expectations about Our Work in Check
Chapter Three BEHAVIOR MANAGEMENT
Environment and Human Behavior
The Impact of Fear
Meeting Needs
Initiating a Proactive Mindset
Verbal Interventions Utilized in Behavior Management
Logical Consequences
Physical Interventions
Considering Your Behavior Management Program
Chapter Four HUMAN STAGE DEVELOPMENT
The New American Culture
Theories of Childhood Development
Different Learning Styles in Youth
Universal Needs of Children
Considering All Things
Chapter Five ISSUES OF GRIEF, LOSS, AND TRAUMA
Victimized Children Have Issues of Grief, Loss and Trauma
The Stages of Grief
Behavior Brought on by Loss
Ways to Help Children Cope
Using Creativity to Express Feelings
Symptoms of Trauma
Post-Traumatic Stress Disorder
Symptoms of PTSD
Managing PTSD in the Milieu
Secondary Trauma
Next Steps
Chapter Six ETHICS IN OUR FIELD
Our Walls of Silence
Physical Restraints and Staff Training
Ethical Codes in the Child Care Profession
Ethics in the Agency and Children’s Rights
Examining Ethics in Our Field
Chapter Seven THE IMPACT OF “NO-PHYSICALCONTACT” POLICIES
Touching Around the Globe
Researching the Issues with Involved Parties
Views on “No-Physical-Contact” Policies
Contradictions between Policy and Practice
Impact of “No-Physical-Contact” Policies on the Staff-Client Relationship
Reviewing Common Themes
Summarizing the Physical Contact Debate
Chapter Eight DEVELOPING A FAMILY CENTERED APPROACH
Offering Families Support Instead of Criticism
Family Is an Entitlement
Components of Family Work
Permanence Cannot Be Achieved in All Families
Paternal Deprivation
Advocating for Children and Families
Chapter Nine ESTABLISHING DIVERSITY IN THE MILIEU
Cultural Competence
Multiculturalism in the Residential Setting
Culture as It Defines Children in Residential Placement
Making the Milieu Reflect the Ethnic Diversity of All Children
The Story of Jeffery
Just People Helping People
Chapter Ten MANAGED CARE, MERGERS, NETWORKS AND ACCREDITATION
Managed Care and Medicaid
Privatizing Public Agency Responsibilities
The Rationale for Non-Profit Mergers
Networks in the Child Welfare Field
Discerning Potential Partnerships
The Benefits of Accreditation
Change Is Here
Chapter Eleven SUGGESTIONS FOR FUTURE PRACTICE
Practices Requiring Little or No Additional Funding
Practices that Require Additional Funding
Discerning the Ideal System
Facing the Future of Change within Organizations
Appendix: CODE OF ETHICS
Bibliography
Glossary
Resources