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A Look at the Legal Side of Residential Programs for Children

Before entering a residential treatment center, the child must agree to enter the program in order for the program to be able to operate. The child does not sign the contract when entering the program. If there is a signing ceremony, the parents sign the document after the child has signed. The child does not need to consent to any document that affects his or her right to liberty and confidentiality. A dispute arises when a child does not want to attend a treatment center. This becomes the parental or legal responsibility.

In the legal realm, this is known as a “refusal of service.” The parent(s) can file suit and take legal action to force the program to admit the child to the program. If there is an agreed-upon court order or “directive,” the treatment center has to comply. Refusing to accept a child into the program after the court order is in place is illegal. If the court order is not fulfilled, there is the risk of being found in contempt of court, which results in fines and/or jail time.

Although there is no easy way to determine a child’s wishes, guardians may be empowered to make decisions on behalf of their child if they are capable. These decisions must be communicated to the treating team, and the child must be informed of the guardian’s decision. Parents may also be empowered to decide on behalf of their children to leave a program at any time. After leaving a residential treatment center, a child’s life remains the same as it was before the program started. Parents of children with long-term attachment issues may be faced with similar challenges that they face in the early years.

Children may leave the program with a serious attachment disorder.It is the job of the treating team to be aware of attachment issues and to keep these issues in mind throughout treatment. After release, the treating team must continue to keep these issues in mind. This ensures that the child’s attachment disorder remains managed. Addressing the main issues of attachment:

Letting go of a child’s attachment to her parents or caregivers in this process, the child must learn to detach from the attachment or allow it to continue.

These issues are part of the daily work of a therapist or teacher. When a child can detach from the attachment or allow it to continue, the child can make new attachments to other caregivers and people. The expert society for working with children, NASPARC, has a five-step model for working with children who are attached to one or both of their parents or caregivers. “Oddly enough,” they say, “these same skills can be used in families without children who are attached.” The NASPARC model is often implemented in group therapy sessions for children who are recovering from a separation or divorce.

At the root of this model is the observation that a child’s attachment pattern is an imprint of the family that he or she was born into. If the family has no secure attachment between children, then any other adult the child comes in contact with will be a stranger since children develop the ability to distinguish between familiar faces. A child who develops secure attachment is able to form attachments to familiar caregivers that are balanced and compatible. The child has a strong capacity to regulate the emotional tone of the relationship so that the parent can contribute to the child’s development but is capable of going off on his own when the parent’s presence is no longer needed for his development.

It is often helpful to help the child navigate his developing relationship with a new parent, whether it be a new sibling, adoptive parent, friend, or caregiver, and use a ‘parent coaching’ style to help him or her through this process.

Parent coaching involves promoting the child’s development of attachment and the child’s ability to do so as well.

In this way, the parent is able to step out of the immediate response of a mother/child relationship and support the child’s development of attachment skills. In children, a key attachment-related issue is “parent-child boundary violations.” In childhood, physical touch is highly important in forming healthy bonds.

For many children, abuse or neglect at the hands of an adult close to the child’s developmental stage causes intense pain. “Parent-child boundary violations” involve the child’s denial of his or her feelings by the child’s intentional acts that are detrimental to the parent/adult relationship.

For example, a child could use her body to deflect attention away from her mother’s negative feelings or reject her mother’s comforting touch. As a result, the child becomes comfortable violating the boundaries established between parent/child to break the connection.

These types of issues can be solved with therapy and support from the other adults in the child’s life. But, ultimately, the role of attachment in establishing self-control and self-regulation is still unknown.