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Pros and Cons of Therapeutic Boarding Schools (TBS) and Residential Treatment Centers (RTC) for Troubled Teens

Pros and Cons Therapeutic Boarding School or Residential Treatment Center -

Updated on March 27, 2024

What is a Therapeutic Boarding School?

Residential private schools used to be called “boarding” schools but are now simply called private schools. Parents often send their children to private schools that include faith and/or cultural beliefs in their curriculum.

Although a therapeutic boarding school is also a type of private school, it is specifically designed to help troubled kids with psychological, emotional and developmental learning issues.

Children attending therapeutic boarding schools remain at school 24/7 instead of returning home each day.

Unlike private or public schools, where one teacher typically has a class size of 20 to 30 students, therapeutic boarding schools’ student/teacher ratio is much lower, usually one teacher for every five to 10 students.

In addition, these schools provide psychological counseling, holistic activities, regular health screenings and many other services that effectively address the needs of at-risk youth.

Teens attending a therapeutic boarding school frequently have one or more of the following behavioral and emotional problems:

  • Asperger’s Syndrome
  • Oppositional Defiant Disorder (ODD)
  • Learning disabilities
  • Bipolar disorder
  • Substance abuse disorder


Upon a comprehensive assessment of a child’s needs, educators at therapeutic schools craft a personalized study program.

This tailored approach ensures that each child’s strengths and weaknesses are addressed, with regular reviews and adjustments to optimize their progress.

For instance, if a 14-year-old student like Mary struggles more with mathematics than English, her program may include a more intensive focus on math subjects.

Understanding Residential Treatment Centers (RTC) vs. Therapeutic Boarding Schools (TBS)

mental health care in residential treatment centers (RTC)

A residential treatment center (RTC) for troubled teens emphasizes psychological therapy and counseling over academics.  

They also offer shorter stays for teens, usually six months or less, and have fewer kids living at the center during treatment. 

Residential Treatment Centers: Comprehensive Clinical Care

While therapeutic boarding schools offer 24/7 supervision, a Residential Treatment Center offers around-the-clock clinical care.

The clinical team often includes a physician or physician’s assistant available 24 hours a day, nurses, and reputable RTCs are staffed with psychiatrists, psychologists, therapists, and on-call physicians.

An RTC is equipped to offer medical or psychological care as needed and tends to be stricter, catering to kids with substance abuse issues, mental health challenges, comorbidities, conduct disorders, those who have attempted self-harm, or are suffering from teen trauma or PTSD.

Residential treatment centers are recognized as medical facilities and typically accept most health insurance plans to cover a teen’s treatment.

An RTC is ready to provide medical or psychological care as needed and is stricter since kids at RTCs are likely to have substance abuse issues, mental health issues, comorbidities and conduct disorders or have attempted to harm themselves or are suffering from teen trauma or PTSD. 

Residential treatment centers are considered medical facilities and accept most health insurance plans–pay for a teen’s treatment.

Therapeutic Boarding Schools (TBS): Academic Focus and Behavioral Therapies

Therapeutic boarding schools emphasize academics and actively incorporate behavioral and psychological therapies in a child’s school program.

Students usually stay for longer durations (at least one year) and live in a less restrictive environment compared to an residential treatment center.

Unlike residential treatment centers, therapeutic boarding schools are primarily staffed by educators and counselors, often collaborating with local therapists to care for the students. These schools focus on academic and behavioral improvement and do not accept health insurance for payment.

Making the Right Choice for Your Child

Deciding Between RTC and TBS

Deciding whether your child should attend a residential treatment center or a therapeutic boarding school involves careful consideration and input from your child’s therapist, school counselors, and other mental health professionals.

Typically, children attending a Therapeutic Boarding School have less complex mental health issues and require specialized assistance to achieve academic success appropriate for their age group. They often thrive in a more stable, structured environment.

Who Benefits from Residential Treatment?

Teens in a residential treatment program often have complex psychological and emotional issues that require intensive counseling. Many need medication-assisted treatment (MAT) and extra mental health support for dealing with trauma in their lives. Academic classes are provided for kids in residential treatment to keep them up-to-date with peers in school. 

Accreditations Standards for Therapeutic Boarding Schools and Programs

Accreditation for therapeutic boarding schools can be awarded by prestigious academic organizations such as the National Independent Private Schools Association (NIPSA) or the New England Association of Schools and Colleges. These recognitions ensure that the educational components of therapeutic boarding schools meet rigorous academic standards.

The National Association of Therapeutic Schools and Programs (NATSAP) serves as a valuable resource for parents navigating the complex decision of choosing a therapeutic boarding school for their child.

Established over two decades ago, NATSAP is a non-profit organization offering voluntary membership to a wide range of therapeutic care providers, including wilderness therapy programs, residential treatment centers, and therapeutic boarding schools.

To become a member of NATSAP, a school or center must possess one of two essential credentials. They must either be licensed by the state’s regulatory agency authorized to enforce standards for therapeutic schools and residential treatment centers for troubled youth, or they must have accreditation from a reputable youth behavioral health accreditation organization. 

Accreditations by a youth behavioral accreditation organization must ensure the provision of therapeutic services by a qualified mental health clinician. Affirming the program’s commitment to high-quality care and oversight.

Accreditation for Residential Treatment Center

Pros and Cons of Therapeutic Boarding Schools (TBS) and Residential Treatment Centers (RTC) for Troubled Teens Troubled Teens

Residential treatment facilities prioritize seeking accreditation, a process requiring renewal by national and state-recognized organizations.

To receive accreditation, residential treatment centers must complete an evaluation and demonstrate quality, safety, high therapeutic standards, effective treatment modalities like individual therapy, group therapy, and family therapy, and strong therapeutic practices


Moreover, the clinical staff must be licensed and accreditations must be renewed every one to three years. An advantage of accreditation is that insurance companies typically only reimburse claims from accredited facilities.

What Kind of Programs are Offered By Accredited Therapeutic Boarding Schools?

In addition to individualized academic programs, therapeutic boarding schools may also provide one or more of the following programs:

  • Individual, group and family therapy sessions
  • Art, music and creative writing
  • Equine therapy
  • Holistic activities (outdoor exercise, yoga, meditation techniques
  • Improving communication, decision-making, self-efficacy and anger management skills
  • Developing healthy relationships with others


Interwoven with these programs are a variety of age-appropriate social activities to allow teens to use these new skills for developing positive friendships with peers.

Some therapeutic schools encourage kids to engage in activities outside the school that can strengthen their self-esteem and sense of self-worth.

Volunteering to assist local nonprofit organizations or offering their services to help a community project works wonderfully to help troubled teens start to heal and feel better about themselves.

Residential Treatment Centers for Troubled Teens Offer Comprehensive Care and Therapies

Residential Treatment Centers (RTCs) offer a wide range of clinical and diagnostic services for troubled teens, including personalized treatment plans managed by dedicated medical and psychological professionals.

Accredited RTCs provide 24/7 crisis intervention, as well as various levels of care ranging from entry-level to intensive, designed to meet the unique needs of each teen.

These levels of care combine inpatient treatment with focused services to ensure stability and structure. Additionally, RTCs offer a blend of therapeutic approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), group therapies, and experiential outdoor activities, alongside academic support.

The most effective RTCs seamlessly integrate medical treatment with academic programs, preparing teens for a smoother transition to therapeutic boarding schools once they’ve completed their residential treatment phase.

Understanding the Cost of Therapeutic Boarding Schools and Residential Treatment Centers.

The decision to place a child in a therapeutic program is complex, and cost is a major factor. Let’s break down the expenses and potential funding sources.

How Much Does Therapeutic Boarding School Cost?

The average cost for one child to attend a therapeutic boarding school varies between $4,000 and $13,000 per month on average.  Although in certain parts of the US you can find more affordable therapeutic boarding schools, these are usually smaller niche schools like Christian Boarding Schools.

These specialized schools often provide tailored educational and therapeutic programs that cater to specific beliefs or needs, making them an attractive option for families seeking a more personalized approach.

It’s important for parents to conduct thorough research and consider a school’s accreditation, philosophy, and treatment efficacy when exploring these more affordable school alternatives.

Even though insurance won’t cover the cost of sending a child to a therapeutic school, there are alternative ways to manage tuition expenses.

Alternative Funding Options 

  • Financial Aid from Charitable Organizations: Church groups, community networks, and some non-profit organizations may offer financial assistance for therapeutic programs.
  • Veteran Benefits: Qualifying veterans may access low-interest personal loans to help cover costs.
  • Crowdfunding: Platforms like GoFundMe can help raise funds to defray tuition expenses.
  • Creative Financing: Consider low-interest credit cards, personal loans, or even a second mortgage (as a last resort) to bridge the financial gap.


Using Your 529 Savings Plan and Therapeutic Boarding Schools

Parents who have a 529 savings plan for their children should check with their bank to see if they can take a portion of the funds from this plan. According to the U.S. Securities and Exchange Commission, every state sponsors at least one of two types of 529 plans: education savings plans or prepaid tuition plans. 

Parents may be able to use a 529 plan to pay for the following:

  • Therapeutic boarding school tuition
  • Supplies and textbooks listed in their child’s academic syllabus
  • Tablets, computers and printers needed for school work
  • Adaptive equipment for special needs students (speech-to-text devices, wheelchairs, etc.)


Parents should be aware that a 529 account won’t pay for transportation to and from school or fees for extracurricular activities.

To Explore Eligibility please check with your bank or financial advisor to see if your child’s 529 plan qualifies for therapeutic boarding school expenses.


Financial Aid for Special Circumstances

  • The Adoptive Families Coalition (AFC): This non-profit offers financial aid to adoptive families for therapeutic programs, including boarding schools. (Contact: 602-740-7149)
  • National Association of Crime Victim Compensation Boards (NACVCB): Provides financial assistance to families whose child needs a therapeutic program due to a serious crime. (Requires police report documentation)

Struggling with Your Teenager's Behavior?

When you've tried everything and it seems like nothing is working, it's understandable that you might feel overwhelmed. But remember, there's always a path forward. It could be time to consider a different approach: a therapeutic residential treatment facility.


Discover A New Path: Give Your Teen A Fresh Start Today!

How Much Do Residential Treatment Centers Cost?

The average cost of one child to attend a Residential Treatment Center can range between $26,000 and $75,000 per month. Fortunately, many health insurance companies offer reimbursement or direct payment for crisis mental health treatment. 

Accredited residential treatment programs are considered “out-of-network-treatment providers.” While coverage varies, but many insurance companies provide “crisis services” for the initial thirty days of treatment. After that they may partially or fully cover mental health treatment for six to eight months. 

Many private or employer-provided insurance plans offer mental health benefits, including coverage for:

  • RTC (Residential Treatment)
  • PHP (Partial Hospitalization)
  • IOP (Intensive Outpatient)

Before choosing an RTC, verify its licensing and accreditations. Insurance companies often prefer programs offering step-down levels like PHP and IOP.

Coverage for RTCs typically lasts one to two months. However, facilities offering step-down programs may receive extended insurance funding, sometimes up to six to eight months of partial reimbursement.

We recommend consulting the admissions team of any RTC you’re considering. They usually have staff dedicated to verifying insurance coverage and benefits.

“If you are a family in crisis and you have a kid for whom outpatient treatment is not an option, you hope to be able to call the closest residential facility to you and have access to timely, safe, affordable care for your child,”

The Pros and Cons of Therapeutic Boarding School (TBS) for Teens

Pros of Therapeutic Boarding School (TBS)

  • Strong Academic Focus: Students receive individualized attention to catch up or excel academically.
  • Structured, Supportive Environment: Consistent routines, healthy habits, and positive peer groups aid in emotional and behavioral growth.
  • Development of Life Skills: Teens learn responsibility, communication skills, and coping mechanisms for long-term success.
  • Holistic Approach: Often includes therapy, counseling, and activities designed to promote well-being and self-discovery.
  • Longer Duration: Extended stays (often a year or more) allow for deeper, more transformative change.


Cons of Therapeutic Boarding School (TBS)

  • Cost: Can be very expensive, and health insurance typically doesn’t cover costs.
  • Less Intensive Therapy: Focus is on academics and behavioral adjustment, may not be suitable for teens with severe mental health conditions or complex trauma.
  • Adjustment Period: Being away from home can be challenging for some teens.
  • Parent Involvement: Parental participation in family therapy might be limited based on distance.

The Pros and Cons of Residential Treatment Centers for Troubled Teens

Pros of Residential Treatment Centers (RTCs) for Teens

  • Intensive, 24/7 Care: RTCs offer round-the-clock clinical support by psychiatrists, therapists, and medical professionals, crucial for teens facing severe or complex mental health issues.
  • Crisis Management: Designed to manage behavioral crises, substance abuse, and situations where a teen might be a danger to themselves or others.
  • Addressing Acute Needs: RTCs focus on immediate stabilization and intensive treatment, often in a shorter timeframe compared to other programs.
  • Medical Oversight: Many teens with complex mental health diagnoses benefit from the integrated medical care offered on-site at an RTC.
  • Insurance Coverage: Health insurance plans often cover RTCs, potentially lowering out-of-pocket costs for families.


Cons of Residential Treatment Centers (RTCs)

  • Restrictive Environment: Rules and schedules in RTCs can be very strict, with limited freedom compared to a therapeutic boarding school.
  • Focus on Treatment over Academics: While education is provided, the primary goal of RTCs is intense mental health treatment and stabilization.
  • Transition Considerations: Teens often need to step down to a less intensive program, like a therapeutic boarding school or outpatient therapy, for ongoing support after leaving an RTC.
  • Potential for Stigma: RTCs sometimes carry a negative stigma, although this is changing as mental health awareness increases.
  • Cost: Even with insurance, RTCs can be expensive with potential for out-of-pocket expenses.

Remember: The best choice depends heavily on the teen’s specific needs and severity of their condition. Consult with mental health professionals to determine if an RTC is the right fit.

How We Help Parents Like You Find the Right Program for Your Child

Troubled Teens offers a comprehensive resource guide to help parents find a therapeutic boarding school that fully addresses their child’s academic, emotional and psychological needs. If you would like more assistance, contact us today to speak to a knowledgeable representative.

If you’re considering a therapeutic boarding school for your teen, be sure to read our comprehensive guide to these programs.

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Speak to an expert about Pros and Cons of Therapeutic Boarding Schools (TBS) and Residential Treatment Centers (RTC) for Troubled Teens and your teenager.

Connect with an Admissions Counselor who specializes in "comorbidity, mental health treatment" to help your teen begin their recovery today.

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