A behavior modification facility (or youth residential program) is a residential educational and treatment institution enrolling adolescents who are perceived as displaying antisocial behavior, in an attempt to alter their conduct.
Due to irregular licensing rules across countries and states, as well as ambiguity regarding the labels that facilities use themselves, it is hard to gauge how widespread the facilities are.[1] The facilities are part of what has been called the Troubled Teen Industry. Programs in the United States have been controversial due to widespread allegations of abuse and trauma imposed on the adolescents who are enrolled, as well as deceptive marketing practices aimed at parents. Critics say the facilities do not use evidence-based treatments.
Practices and service quality in such program vary greatly. The behavior modification methodologies used vary, but a combination of positive and negative reinforcement is typically used.[2] Often these methods are delivered in a contingency management format such as a point system or level system.[3] Such methodology has been found to be highly effective in the treatment of disruptive disorders (see meta-analysis of Chen & Ma (2007).[4]
Positive reinforcement mechanisms include points, rewards and signs of status,[5] while punishment procedures may include time-outs,[6] point deductions, reversal of status, prolonged stays at a facility, physical restraint, or even corporal punishment. Research showed that time out length was not a factor and suggestions were made to limit time out to five minute durations.[6] A newer approach uses graduated sanctions.[7] Staff appear easily trained in behavioral intervention, such training is maintained and does lead to improved consumer outcomes, as well as reduce turn over.[8] More restrictive punishment procedures in general are less appealing to staff and administrators.[9]
Behavioral programs were found to lessen the need for medication.[10] Several studies have found that gains made in residential treatment programs are maintained from 1–5 years post discharge.[11] Therapeutic boarding schools are boarding schools based on the therapeutic community model that offers an educational program together with specialized structure and supervision for students with emotional and behavioral problems, substance abuse problems, or learning difficulties. Some schools are accredited as Residential treatment centers. http://www.strugglingteens.com/artman/publish/article_5382.shtmlhttps://web.archive.org/web/20070614041025/http://www.schools.utah.gov/curr/accred/reports/TeamReports/WestRidgeAcad.pdf
Behavioral residential treatment became so popular in the 1970s and 1980s that a journal was formed called Behavioral Residential Treatment, which later changed its name to Behavioral Interventions. The journal continues to be published today.
In the late 1960s, behavior modification or practice referred to as applied behavior analysis began to move rapidly into residential treatment facilities.[12] [13] The goal was to redesign the behavioral architecture around delinquent teens to lessen chances of recidivism[14] and improve academics.[15] Harold Cohen and James Filipczak (1971) published a book hailing the successes of such programs in doubling learning rates and reducing recidivism.[16] This book even contained an introduction from the leading behaviorist at the time, B.F. Skinner hailing the achievements. Independent analysis of multiple sites with thousands of adolescents found behavior modification to be more effective than treatment as usual, a therapeutic milieu, and as effective as more psychologically intense programs such as transactional analysis with better outcomes on behavioral measures;[17] however, these authors found that behavior modification was more prone to leading to poor relationships with the clients.[17] Over time, interest faded in Cohen's CASE project.[18] Other studies found that in proper supervision of staff in behavior modification facilities could lead to greater use of punishment procedures.[19]
Under the leadership of Montrose Wolf, Achievement place, the first Teaching Family Home became the prototype for behavioral programs.[20] Achievement place opened in 1967. Each home has from 6-8 boys in it with two "parents" trained in behavior modification principles. The token system for the program was divided into 3 levels. Outcome studies have found that Achievement place and other teaching family homes reduce recidivism and increase pro-social behavior, as well as self-esteem.[21] [22] While initial research suggested the effects of the program only lasted for one year post discharge, recent review of the data suggests the program lasts longer in effect.[23]
Gradually, behavior modification /applied behavior analysis within the penal system including residential facilities for delinquent youth lost popularity in the 1970s-1980s due to a large number of abuses (see Cautilli & Weinberg (2007) [24]), but recent trends in the increase in U.S. crime and recent focus on reduction of recidivism have given such programs a second look https://archive.today/20041231155321/http://www.ftnys.org/juv.htm.[25] [26] Indeed, because of societal needs the number of youth residential facilities has grown over recent years to close to 39,950 in 2000.[27] The use of functional analysis has been shown to be teachable to staff and able to reduce use of punishment procedures.[28] Rutherford's (2009) review from interviews and archival materials documents the decline from treatment of behavior analysis with criminal justice populations.[18]
These facilities are part of what has been described as the Troubled Teen Industry.
Studies of successful graduates have shown that boot camp programs as an alternative to prison time are particularly successful in reducing criminality, but these studies are limited to successful graduates of state correctional and prison-alternative programs managed by current and former military service members.[29] Programs such as teaching family homes based on the Teaching-Family Model have been researched by industry funded organizations and show positive gains. Research shows that they can be used to reduce delinquency while adolescents are in the home and post release