Devereux  Advanced Behavioral Health Massachusetts & Rhode Island

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Devereux Massachusetts Residential Program

Providing evidence-based, trauma-informed care for boys

The Devereux Massachusetts Boys’ Program serves males, ages 9 to 21, across a continuum of treatment settings, including three campus units and two community-based residences. The focus of the campus units is stabilization, and to help individuals develop safe and effective coping strategies; increase prosocial skills; and improve daily living skills. Boys who are successful in the campus setting can progress to one of our community-based residences located in Rutland, Mass. The programming in these residences emphasizes independent living skills and community integration.

The therapeutic milieu of the Boys’ Program uses relational strategies and positive behavior support strategies to decrease challenging behaviors and foster the development of effective communication and coping skills. The Therapeutic Behavior Change System (Step System) reinforces these concepts through its focus on validation, skill coaching, the use of restorative tasks (e.g., repairs), and the use of logical/natural consequences to address socially unacceptable behaviors. Throughout the continuum of care, individuals are exposed to numerous milieu-based groups including, but not limited to, a milieu skills group, which merges dialectical behavior therapy and Aggression Replacement Training, as well as adventure-based counseling, Preparing Adolescents for Young Adulthood (PAYA), fitness, therapeutic recreation groups, sex education and substance abuse education.

Admission Criteria

Our Boys’ Program serves child and adolescent males who present with a variety of social, emotional and behavioral issues, including: disruptive behaviors, mood/anxiety disorders, complex trauma, psychotic symptoms, high-functioning pervasive developmental disorders, and abuse-reactive behaviors.

Eligible children/adolescents are/have:

  • 9 to 21 years old
  • Intellectual functioning ranging from mild intellectually disabled to average
  • A diagnosable mental disorder of sufficient duration to meet criteria specified in DSM-IV, a diagnostic and statistical manual of mental disorders
  • Functional impairment that substantially interferes with, or limits, the child’s functioning in family, school and community activities
  • Less restrictive forms of treatment have been attempted, and have not been effective

Admissions Procedure

Contact the Admissions Department by phone at (508) 886-4746 or by email at MA_Admissions@devereux.org.

Mission Statement

The mission of the Devereux Massachusetts Boys’ Residential Treatment Program is to teach individuals the skills they need to function as independently as possible in the most normalized, family-like setting appropriate to their developmental level and cognitive, emotional and social abilities. In order to accomplish this mission, we offer a safe, warm, predictable and empathic environment that helps individuals stabilize their behavior and learn the specific skills needed to achieve their goals. We provide a continuum of treatment settings that encourage progressively greater levels of self-management. We work with families, involving them in their child’s treatment and supporting them in caring for their child.

Program Objectives

• Decrease unsafe, challenging behaviors (e.g., self-injury, aggression, running)

  • Increase use of prosocial, coping strategies
  • Learn how to self-manage psychiatric symptoms
  • Develop age-appropriate functional living skills
  • Improve academic achievement and plan the next academic and/or vocational step
  • Improve family relationships and increase behavioral stability in home environment (if applicable)
  • Reintegrate into a community setting with the skills necessary to maintain an adequate level of functioning

Treatment Components

Our program is based on three assumptions about the development of problem behavior in the individuals we serve.

  1. Problem behavior is the result of individuals trying to meet their needs without having the necessary skills. They attempt to get what they need in socially inappropriate, self-defeating ways.
  2. Problem behavior occurs when the demands placed on an individual cause him to become emotionally over-aroused. Individuals can easily become emotionally and behaviorally dysregulated by the demands of the environment.
  3. All behavior, including problem behavior, is caused by interactions between people, and never caused by just one person. The way we relate to an individual, or respond to his behavior, is important in determining how he acts.

These assumptions suggest we should focus our efforts on helping youth in the following areas:

  1. Teaching Skills: If we want to have a lasting impact on an individual’s behavior, we have to teach him skills that will enable him to meet his needs in more appropriate ways. These are called replacement skills because they replace problem behaviors. Individuals often misbehave in order to connect with others. Lacking the skills to relate appropriately, they resort to problem behavior to engage others. One important way to change problem behavior is to teach individuals replacement skills, especially positive ways to connect with others.
  2. Changing the Environment: An individual cannot learn new skills if he feels overwhelmed or unsafe. In such an environment, individuals become disorganized and out of control. This is especially true of individuals with a history of trauma who are easily overwhelmed by unstructured or highly stimulating environments. One way to change problem behavior is to change the environment to help individuals control their behavior and emotions. Program services include:
    • Residential milieu utilizing a relational approach and positive behavioral support
    • Individual, group and family therapy
    • Parent involvement
    • Medication management
    • Therapeutic recreation
    • Special needs school

To help those in our care address their mental health issues, we employ the following approaches:

  • Trauma-informed care: Many of the individuals we serve have a history of abuse and/or neglect. We have learned that trauma affects the functioning of the brain. Long-term effects of trauma include difficulty controlling emotions; poor impulse control; and distrust of others. Youth who have a history of trauma have learned to distrust adults and expect disappointment, rejection and abuse in their relationships. In addition, traumatized youth have often failed to learn the basic skills of how to form relationships. These skills include the ability to talk about his own feelings; tuning in to another person’s feeling; the ability to see things from another person’s point of view; and the ability to follow social rules.
  • Relational approach: Positive, healthy relationships between individuals and staff are the most important factor in creating a treatment environment that is safe, warm, predictable and empathic and helps individuals feel competent and successful. All learning occurs in the context of relationships, and behavior change techniques are most effective when they are employed in the context of a positive relationship. We have adopted a training curriculum to help staff learn how to form positive relationships with children affected by trauma. The Risking Connection training curriculum is centered in the belief that a collaborative healing relationship is one marked by respect, information, connection and hope (RICH).
  • Positive behavioral support: Positive behavioral support emphasizes assessment prior to intervention; manipulation of antecedent conditions to reduce or prevent the likelihood that a problem behavior will occur; development of new social and communication skills that make problem behaviors irrelevant; and careful redesign of consequences to eliminate factors that maintain problem behaviors and to encourage more acceptable replacement social skills and behaviors.
  • Dialectical behavior therapy (DBT): DBT assumes that: 1) individuals are doing the best they can: 2) individuals want to improve; 3) genuine compassion is essential to meaningful change; and 4) behavioral principles of learning apply to both youth and staff. DBT emphasizes the coaching of skills in an individual’s natural environment. Helping youth use the skills they learn in psychotherapeutic groups during real-life situations is critical for progress. DBT skills are an important component of the residential milieu skills groups.
  • Aggression replacement training (ART): ART is a treatment program based on the assumption that aggression is a learned behavior. More specifically, social learning experiences of aggressive youth have not taught them the interpersonal and cognitive skills that constitute effective prosocial behavior. Another assumption of ART is that certain youth exhibit an over-reliance on aggressive means to meet their daily needs and longer-term goals reflecting a deficiency in anger control. ART skills are an important component of the residential milieu skills groups.
  • Family involvement: Family plays a central role in the life of an individual, whether or not the discharge goal is family reunification. Therefore, we strive to involve families in the assessment and treatment of their children.