The short answer is, it depends on the state and how the state licenses residential programming. There is no national standard and so each of our fifty states have the responsibility to set their own licensure requirements for private-pay residential programming; many states divide up the enforcement between numerous governmental departments and some states do not even regulate private-pay residential care. Because the scope and specifics of state regulations vary so much, and because some states do not require independent licensure at all, the member organizations NATSAP and OBH Council require their members to be licensed by their state or to carry an independent Joint Commission or Council on Accreditation (COA) certification. (OBHCouncil is presently integrating a third-party accreditation with the Association for Experiential Education for their membership.)
To further complicate matters here in the state of Utah, not all RTC’s are the same level of care in terms of how they operate, starting with their approach to preventing absconding. Some RTCs are staff secured, meaning the doors are not locked but an employee is awake and responsible to manage access; some TBS have magnetically-activated security-doors and are not as “open” as you initially may think.
All of this will get more confusing before it gets easier. This is why the labels do not exist except in definition on the website - because a TBS or RTC in Montana or New Hampshire or Utah has different requirements by the state so when you examine options look beyond what you see in the marketing material or in the name. You are not comparing apples to apples — there are very many variations and sizes and individual differences.
When you are comparing programs on this website, be sure to compare the many ways programs can be different; check the therapist to student ratio, investigate the academic rigor, visit the location, compare the model and your child and inquire about the approach when it is not a perfect fit… Ask for specifics and examples.
When you are comparing programs between states, communicate with the state licensing body. Ask the state for their latest review and if the program has ever had a violation or restriction against its license. Different states require different types of communication with family. Some states grant parents the right to enroll a teen until they are 18 years old and other states require teens participate voluntarily after their 14 or 16th birthday. Most state licensing agencies will direct you to the actual form their auditors use (for example, here’s Utah’s “Residential Treatment Rules Checklist”)
TO VISIT OR NOT TO VISIT
Making a placement for a child or teen can be an incredibly wrenching, significant decision for a parent to make, and usually feels extremely urgent, as well. When you are making this decision, ask questions, visit & verify for yourself. Many families use therapeutic consultants for their process and even if you do, you are missing an opportunity by not visiting yourself. In the end of a day, there is no perfect program and if your teen is struggling there, knowing who the person is on the other end of the phone a time zone or two away is invaluable (even when you have a consultant). You are making a decision that will impact your whole family and you have to trust the people who you have entrusted your teen to. You have to know that the staff, teachers, therapists, and administrators care for your teen and want what is best for him/her. If you do not trust the program, you should keep your kiddo at home; your distrust will undermine the process and waste your money. Websites are pretty interactive these days (this one included), but they do not take the place of a visit. You should see with your own eyes the features that you think are important and meet the staff or therapist (horses, gardening, recreation therapy, community service, and see how many students participate in these events, or are the photos only “marketing”).
Generally, programs will allow you time with their students without a staff or therapist in the room, as long as you respect program obligations to their current families’ privacy and do not seek information about the students directly. So, if you meet with current students, find out how long each student has been in the program. You must not ask the students why they are at this program, or potentially identifiable information (last names, home town, etc.) You may ask if they completed a therapeutic wilderness program as this gives you some context for their answers and also provides some ability to understand an appropriate placement.
Different programs have different “feels” to them - they have different types of populations, they have different features… the usual routine and how they interact with kiddos is different. If you have a therapeutic consultant guiding you through, wonderful - Ask questions and then visit. You are about to entrust your child/teen to someone outside the home, for a significant amount of time. Didn’t you visit your college or university before you went? Just because you are in the crisis does not mean you skip the most important step.