Q. I have a 14-year-old son who has attention deficit disorder (ADD) and has continued to show signs of inappropriate behavior--disrespect, delinquency issues, sexual boundary issues. I want to find a residential treatment facility that would include school, behavioral modification program, therapy for sexual deviancies, working on empathy--respect for others.

I want a program that is known for a good outcome for its residents. Any suggestions on how to find the right program? What hidden problems lie with such programs and how would I avoid missing signs of problems with treatment centers?

A. This sounds like a painful and difficult situation for you, your son, and your family. Some of the problems you describe in your son sound like they fall outside the boundaries of attention deficit hyperactivity disorder (ADHD) alone, and may reflect the presence of some other psychiatric disorder.

For example, bipolar disorder is sometimes not diagnosed in this age group, and the adolescent's behaviors are mistakenly attributed solely to ADHD. I'm not saying this is the case with your son, but--prior to initiating placement in a residential setting--you may want to consider obtaining a second diagnostic opinion from an expert in adolescent psychiatry.

That said, you can find information about residential settings at the website www.treatment-resources.com (or call 888-435-7711). Another site that provides information is the Casey Family Programs, www.casey.org. You can also find helpful links at the website of the American Academy of Child & Adolescent Psychiatry (www.aacap.org).

That said, there is really no substitute for speaking with knowledgeable professionals who are familiar with the particular facility you are interested in. For example, speaking personally with psychologists and psychiatrists who have had experience with a particular residential facility is probably more valuable than consulting websites. You could try contacting the community mental health center or Department of Youth Services in the community you are considering for your son, and set up a time to discuss the residential facility in question. Ask about any problems with accreditation, reputation among local clinicians, and any known problems with the facility. And of course, it never hurts to visit the facility and speak with the clinical director to get your own sense of what sort of place it is.

I do hope you find a good solution to the difficult issue you are facing.

Other Resources

• More on Children and Adolescents
• More on ADD/ADHD

December 2002

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