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Introduction: Although adolescents make treatment gains in psychiatric residential treatment (RT), they experience significant difficulty adapting to the community and often do not sustain treatment gains long term. Their parents are often not provided with the necessary support or behaviour management skillset to bridge the gap between RT and home. Parent training, a gold standard behaviour management strategy, may be beneficial for parents of these youth and web-based parent training programmes may engage this difficult-to-reach population. This study focuses on a hybrid parent training programme that combines Parenting Wisely (PW), a web-based parent training with facilitated discussion groups (Parenting Wisely for Residential Treatment (PW RT )). This study aims to: (1) establish the feasibility and acceptability of PW RT , (2) evaluate whether PW RT engages target mechanisms (parental self-efficacy, parenting behaviours, social support, family function) and (3) determine the effects of PW RT on adolescent outcomes (internalising and externalising behaviours, placement restrictiveness)., Methods and Analysis: In this randomised control trial, parents (n=60) will be randomly assigned to PW RT or treatment as usual. Each week for 6 weeks, parents in the PW RT condition will complete two PW modules (20 min each) and attend one discussion group via Zoom (90 min). Adolescents (n=60) will not receive intervention; however, we will evaluate the feasibility of adolescent data collection for future studies. Data from parents and adolescents will be collected at baseline, post intervention (6 weeks post baseline) and 6 months post baseline to allow for a robust understanding of the longer-term effects of PW RT on treatment gain maintenance., Ethics and Dissemination: The study has been approved by The Ohio State University Institutional Review Board (protocol number 2022B0315). The outcomes of the study will be shared through presentations at both local and national conferences, publications in peer-reviewed journals and disseminated to the families and organisations that helped to facilitate the project., Trial Registration Number: NCT05764369 (V.1, December 2022)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Residential treatment is among the most intensive and expensive settings for children with behavioral health challenges; yet, the extent to which evidence-based practices are used in these settings is unknown., Aim: The purpose of this study was to describe the extent which family therapy, case management, telehealth, peer support, and family psychoeducation are provided in residential treatment using data from the National Mental Health Services Survey (N-MHSS). Organizational factors-region, ownership, payment, licensing/accreditation, and facility size-were examined in relation to evidence-based practices to understand disparities in care., Methods: This was a secondary analysis of publicly available data from the 2018 N-MHSS. A subpopulation was created consisting of residential facilities that served children ( N = 576). Descriptive statistics were used to describe the sample, and Cohen's h was calculated to determine patterns of evidence-based practice utilization., Results: Evidence-based practices from most to least prevalent were family therapy (76%), family psychoeducation (74%), case management (71.1%), telehealth (17.2%), and peer support (8.7%). The provision of evidence-based practices was not evenly distributed. There were primarily small to moderate differences by organizational factors, including region (i.e., Northeast, Midwest), ownership status (i.e., for-profit), payment type (i.e., self-pay, private insurance), licensing/accreditation (Department of Family and Children Services), and facility capacity (>251 clients served per year)., Conclusion: Findings demonstrate a need for research-practice partnerships to determine the barriers that prevent effective evidence-based practices from being implemented in the residential treatment setting., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study presents a tiered conceptualization of family partnership developed by the Family-Run Executive Director Leadership Association (FREDLA) with examples of strategies from the literature. This sub-study was part of an overarching systematic review project that aimed to review the literature on family partnership in relation to youth outcomes. The tiers of family partnership include family involvement (i.e. family's inclusion in their child's care); family engagement (i.e. collaboration between TRC and families); family-driven (i.e. families as full partners). This review included thirty studies (n = 23 family involvement, n = 7 family engagement, n = 0 family-driven). The most common family involvement methods were family therapy and family visits to the program, primarily, delivered face-to-face. The most common family engagement method was activities, therapies, and skill building occurring at the home with family present. Methods of measuring family partnership primarily included the use of administrative data. Implications for research and practice include the provision of research that evaluates the effects of family partnership on outcomes important in the TRC setting and the development of research-practice and family-research collaborations to increase the uptake of effective family partnering methods. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that parents with adolescents in residential treatment (RT) may struggle with their own mental health. However, few have comprehensively described parents' mental health using valid and reliable measures and examined parent mental health in reference to other contextual factors that may be intertwined and intervenable. Therefore, the purpose of this exploratory study was to describe the perceived stress, symptoms of anxiety and depression, and post-traumatic stress disorder (PTSD) in parents with adolescents in RT in the United States. This cross-sectional study included a sample of parents (N = 71) with adolescents in RT. On average, parents reported elevated depressive symptoms, moderate stress, mild-to-moderate anxiety symptoms, and subthreshold PTSD symptoms. However, there were differences in mental health based on gender, race, ethnicity, adolescent living location, and adolescent psychiatric diagnoses (e.g., bipolar, depressive, and substance use disorders). Findings provide a more comprehensive description of parents' mental health during the RT admission, underscoring the bidirectionality of parent-adolescent mental health and well-being. Practice Implications Parent mental health screening and treatment may be necessary because of elevated depressive symptoms, anxiety, and stress Parent stress is chronically elevated across the treatment trajectory, highlighting the need for parent preparation, support, and stress management Assessment of trauma and social support is needed because PTSD scores were higher in unpartnered parents Parent and adolescent mental health is bidirectional and providing treatment and support to parents benefits adolescents [ABSTRACT FROM AUTHOR]

The accessibility and use of evidence-based mental health treatment are crucial to children and adolescents with mental health and behavioral health disorders. However, there is little known regarding treatment approaches in residential treatment facilities serving children and adolescents. As mental health disorders affect children and adolescents of all sociodemographic backgrounds, it is important to examine and identify differences in treatment approaches. This study's primary objective was to describe the differences in treatment approaches offered by facilities varying in region, ownership (i.e., private nonprofit vs private for-profit/public), Medicaid status, and client factors (i.e., age, gender, race, ethnicity). Data from the 2018 National Mental Health Services Survey (N-MHSS) was analyzed using Cohen's h to examine the differences in treatment approaches by sociodemographic characteristics in 576 residential treatment facilities. The largest differences in treatment approaches varied by the race/ethnicity and the gender of the client population composition. Particularly, psychotropic medication, seclusion, and restraint were more prevalent when the client composition was majority males, African American or Black, or Native American or Alaska Native. Implications for research and practice related to the intersection of sociodemographic and treatment approaches for research and practice are discussed. [ABSTRACT FROM AUTHOR]