Despite a growing understanding of the need to reduce seclusion and restraint (S/R) in all types of youth psychiatric facilities, published accounts of success in the psychological literature have been limited to inpatient facilities. Furthermore, existing publications on successful S/R reduction rarely include details about implementation that would be helpful to other agencies looking to follow their lead. This article presents the case of one multiservice agency that reduced S/R rates in youth residential and day treatment programs after adopting the Collaborative Problem Solving (CPS) approach. It includes detailed information on implementation, data illustrating the reduction of S/R after CPS implementation, and discussion of possible benefits to youth outcomes and organizational costs.

This is the 13th in a series of papers by the Association of Children's Residential Centers (ACRC) addressing critical issues facing the field of residential treatment. ACRC is the longest standing association focused exclusively on the needs of children and youth who need residential intervention and their families. The purpose of the papers is to stimulate dialogue and self-examination among organizations, stakeholders, and the field.This paper focuses on the overarching goal for all children in out-of-home care to achieve safety, permanence, and well-being, and the role of those providing quality residential interventions in accomplishing this mission. While it particularly focuses on children and youth in the child welfare system, it is applicable to all young people and families. With residential interventions a necessary therapeutic option in community systems of care (Blau, Caldwell, & Lieberman, 2014), it is important that residential providers embrace their critical role in helping children and families move toward permanency and achieve successful outcomes.

ACRC recognizes that all children and adolescents are complex human beings, who may bring to their care with the residential treatment centers many forms of diversity, including diversity of sexual orientation (SO) and gender identity (GI). It is incumbent upon residential treatment centers to ensure that these diversity issues are treated with linguistic and cultural competence in all aspects of these client's treatment from admission through discharge planning. Crucial to delivering high-quality care requires focusing on the intentional creation of safe space, staff training, affirming policies and procedures, and increasing family acceptance.

This is the eleventh in a series of papers issued by the Association of Children's Residential Centers (ACRC) regarding key issues faced by the field in response to emerging research, policy, and best practice. This paper builds on the previous papers in the Redefining Residential Series to address psychotropic medication use in residential treatment. Evidence for use of psychotropic medication with children and youth and the complications presented by youth typically served in residential centers are reviewed. Several critical practices residential programs should consider implementing are identified. Barriers to successful implementation are examined. A call is made for increased emphasis on what is described as rational use of psychotropic medications, prescribed in conjunction with other treatment modalities and careful monitoring of progress and outcomes.

Residential treatment is a potentially powerful intervention for children and families, currently facing the imperative to fundamentally change practice models to achieve greater quality efficacy, efficiency, and effectiveness. Such transformation is best accomplished from a solid foundation which is created by licensing, regulation, accreditation, and internal standards.