Inpatient and residential treatment effects for children and adolescents: a review and critique.

As residential group care has become a less exclusively milieu-based therapy and more a "tapestry of therapies" that involves individual, group, and family therapy, psychopharmacology, intensive case management, special education services, therapeutic recreational activities, and a residential milieu based on therapeutic principles, the practice of providing detailed descriptions of the type of treatment has deteriorated. One might argue, however, that the need for their provision has become ever more important as the calls for improving the scientific quality of the outcome research have become more strident. This is especially true of detailed descriptions of the therapeutic underpinnings involved in the creation and maintenance of a therapeutic residential environment. As Trieschman and his colleagues discussed, a therapeutic residential environment is a place in which residents spend most of their time and have many potentially therapeutic interactions with peers and direct-care staff members.