Now more than ever there is a need to ensure that best practices are being used in residential programs. As the focus on costs and outcomes increase, residential programs must clearly demonstrate that the interventions provided are efficient and effective. Readers will learn how to: Create strength-based, empowering and healing environments; Better engage and partner with children, adolescents and families, in meaningful ways; Support those who have experienced trauma and loss, and to prevent and eliminate the use of restraint and seclusion; Respect and include cultural indices in practices; Train, mentor, supervise, support and empower staff about how to deliver promising and best practices, and evidence-informed and evidence-based interventions; and Track long-term outcomes, and create funding strategies to better support sustained positive outcomes. This book encourages readers to think strategically about how agencies, communities and systems can identify and implement actions that lead to positive change and how to work more collaboratively to improve the lives of children and adolescents who have experienced emotional and behavioral life challenges and their families.

Residential and inpatient treatment of children and adolescents is a field that is still in the process of defining itself and of demonstrating its effectiveness. Because of the continuous nature of the field's development, it is especially important that a broad range of its theoretical orientations and therapeutic techniques be considered and critically appraised. Residential and inpatient treatment is unique in its potential for both positive and negative outcomes. No other interventions can bring about the major changes in all aspects of a child's environment that inpatient hospitalization or residential treatment can. These changes may result in rapid and significant improvements in a child's condition, or they may conceivably lead to additional maladaptive behavioral patterns or inappropriate emotional and cognitive responses. Therefore, the obligation to consider the entire range of treatment alterna tives and to empirically determine the effectiveness of specific interventions is particularly great. Residential and inpatient treatment is also an expensive and limited resource, and our wise utilization of it should be guided by a comprehensive understanding of its benefits and limitations.

The interRAI ChYMH-DD is intended to be used with children and youth with developmental disabilities in mental health settings to support comprehensive care planning, outcome measurement, quality indicators, and case mix classification to estimate relative resource intensity. It employs specific observation periods in order to provide reliable and valid measures of clinical characteristics that reflect the child's or youth's strengths, preferences, and needs. In keeping with other interRAI instruments, the basic time frame for assessment was set at 3 days unless otherwise indicated. Triggers for numerous Collaborative Action Plans to support care planning decisions are also embedded in the instrument. There are two versions of the ChYMH-DD assessment form. Typically, the In-patient form would be used for a child or youth who currently resides in a residential facility or psychiatric facility/unit, and the Community-Based form for a child or youth who resides in a community setting.

First published in 1994. The Sheppard and Enoch Pratt Hospital has been treating severely emotionally disturbed adolescents for a number of years. During this time, they have had the opportunity to build upon the principles and techniques of acknowledged experts and leaders, and have gained a great deal of experience and wisdom ourselves. Our treatment teams had the time to deliver intensive, in-depth treatment, which included three weekly individual psychotherapy sessions, three weekly group therapy sessions, daily activity therapy, and intensive milieu program, daily ward meetings, weekly family therapy, and a daily therapeutic school program. The knowledge and principles described in this book are not only applicable to inpatient facilities but also valuable to practitioners in day hospitals, group homes, and outpatient practice.

Adolescence is a time of major transition, however, health care services in the United States today are not designed to help young people develop healthy routines, behaviors, and relationships that they can carry into their adult lives. While most adolescents at this stage of life are thriving, many of them have difficulty gaining access to necessary services; other engage in risky behaviors that can jeopardize their health during these formative years and also contribute to poor health outcomes in adulthood. Missed opportunities for disease prevention and health promotion are two major problematic features of our nation's health services system for adolescents. Recognizing that health care providers play an important role in fostering healthy behaviors among adolescents, Adolescent Health Services examines the health status of adolescents and reviews the separate and uncoordinated programs and services delivered in multiple public and private health care settings. The book provides guidance to administrators in public and private health care agencies, health care workers, guidance counselors, parents, school administrators, and policy makers on investing in, strengthening, and improving an integrated health system for adolescents.

This issue of Child and Adolescent Psychiatric Clinics, guest edited by Drs. Gabrielle A. Carlson and Manpreet Kaur Singh, is Part II of a two-part issue covering Emotion Dysregulation in Children. This issue is one of four selected each year by our series Consulting Editor, Dr. Todd Peters. Topics discussed in this issue include but are not limited to: Explosive Outbursts at School; Treatment of Childhood Emotional Dysregulation During Inpatient and Residential Interventions; Psychopharmacology of Treating Explosive Behavior; Treating explosive irritability in pediatric bipolar disorders; Evidence Base for Psychosocial Interventions for the Treatment of Emotion Dysregulation in Children and Adolescents; Preventing Irritability and Temper Outbursts in Youth by Building Resilience; Psychoeducational Treatments for Mood Dysregulation; A Modular, Transdiagnostic Approach to Treating Severe Irritability in Children and Adolescents; Longitudinal Outcome of Chronic Irritability; and the future of irritability in children, among others.

Behavior therapists on child and adolescent psychiatric inpatient units have played an increasing role in the treatment of a wide range of disorders. Indeed, behavioral assessment and treatment strategies in these settings have been applied to a diversity of problems, including depression, mental retardation, autism, conduct disorders, attention deficit hyperactivity disorder, anorexia, and bulimia. More recently, the heuristic value of behavioral methods with substance abuse, pediatric pain, and child maltreatment has been documented as well. Because of the multifaceted and complex challenges posed by children and adoles cents who reach inpatient units, behavioral clinicians have worked close ly with other professionals (e. g. , psychiatrists, social workers, psychi atric nurses) in an effort to provide broad-spectrum, comprehensive intervention. However, as a burgeoning body of clinical research attests, the significant contribution of behavior therapy to successful treatment outcome is now indisputable. Yet, surprisingly few texts have been published concerning inpa tient treatment of children and adolescents. The few extant efforts in this area have not covered the broad array of issues and diagnostic popula tions treated, nor have they considered the pragmatic day-to-day diffi culties encountered by behaviorally oriented practitioners working in child and adolescent inpatient settings. This text is an attempt to remedy such shortcomings by providing a comprehensive yet practical approach to the functions of behavior therapists on inpatient psychiatric services for children and youth.