The Relationship Between Program Restrictiveness and Youth Behavior Problems

A key concept in the continuum-of-care model is matching the restrictiveness of treatment to the level of youth behavior problems. Restrictiveness refers to the degree that treatment and setting constrains choices and limits freedoms of patients. Only a few investigators have examined this relationship, and the findings have been equivocal. Extending our initial study of the relationship between youth behavior problems and program restrictiveness, we examined the relationship across seven programs spanning the continuum of care: parent training program, outpatient clinic, family preservation program, treatment foster care, residential group home, acute-care shelter, and inpatient psychiatric hospital. Results indicated a high level of correspondence between restrictiveness and youth behavior problems, with the least restrictive programs serving children with fewer behavior problems and highly restrictive programs serving children with more behavior problems.