How DBT‐A in residential treatment facilities may help to overcome caregiver burden

Findings from the National Mental Health Services Survey indicate that 311,000 adolescents ages 12 to 17 received mental health services through a residential treatment facility (RTF) last year (Center for Behavioral Health Statistics and Quality, 2017). While the structure and approach vary across sites, RTFs are generally out‐of‐home programs designed to focus on behavior management for serious mental illness by using multidisciplinary teams and milieu settings. Adolescents entering residential services often present with multiple diagnoses and high‐risk behaviors that challenge their abilities to navigate relationships, school, and everyday life. Studies on youth in RTFs have found rates upward of 90% of family histories characterized by significant trauma and abuse (Briggs et al., 2012). Placement is typically preceded by violence, law enforcement and/or agency involvement, and a number of failed interventions that are insufficient for such complex cases. Not surprisingly, such problematic behaviors and complicated treatment histories can lead to caregiver burnout, which in turn may interfere with treatment progress. The impact of residential placement on families is often overlooked, even though their adjustment is arguably as essential as the adolescent's. Increasing caregiver involvement and support may lead to a more positive long‐term prognosis for the teen. Thus, a closer look at their personal experiences while teens are placed outside of the home may help us to overcome barriers to providing more effective treatments.