The Barry Robinson Center

Frequently Asked Questions

Who can refer a child

Parents, legal guardians and clinical providers can refer a child to our program with a recommendation from a licensed clinical professional. Our admissions staff works closely with all people involved to determine if a child will benefit from our residential treatment.

How long will I wait for an admission decision?

Typically, our staff can make a determination within two hours. Working with insurance providers for approval may take longer, up to a day or two. Our staff has relationships with many insurance providers, who understand the level of care we offer.

What insurances do you accept?

We accept most commercial insurances, and we are a TRICARE-approved facility. We accept TRICARE East, TRICARE West, TRICARE SOS, as well as TRICARE Prime and Select. We are also approved for Virginia, West Virginia and North Carolina Medicaid.

What do you mean by military-connected?

Military-connected refers to a family where either parent currently serves in or has retired from any branch of the U.S. military.

What geographic area do you serve?

We accept children from anywhere. Children and teens have come to us from more than three dozen states, as well as from families stationed outside of the U.S., in Europe, Asia and elsewhere.

What's an "open campus" environment?

Our 32-acre campus resembles a private school or small college campus, with no institutional “feel.” Most buildings, except for Administration, are locked for safety and security. Our staff members accompany children as they walk to and from the dorms, school, gym, clinical offices and cafeteria.

Do you help out-of-state families with travel or lodging?

We often work with several community partners including a Ronald McDonald House and Mercy Medical Angels to help some families who are traveling to visit children.

What can I bring or send to my child while in treatment?

We provide a family handbook, which details what children can have while on campus. Please check with your child’s unit manager if you have questions.

Does my child have to participate in religious services?

All religious services are voluntary. We do find many children and teens appreciate the services, either by helping organize them or attending. Our spiritual counselor is available to help residents of any faith tradition.

How does BRC compare to other facilities?

Please visit our Comparison Guide (Comparison Sheet)

Can we tour the facility?

Yes. We love to show our campus to prospective families. Tours of the dorms are conducted while residents are in school.

How often is it accredited?

Based on Survey performance, accreditation is good for 1-3 years. BRC was awarded a 3-year accreditation each time we have been surveyed.

What portions of the program are accredited?

All of them are accredited.

Is BRC a for profit or nonprofit organization?

Nonprofit 501c3 Charitable organization

Has the program ever been cited or named in a lawsuit?

No

Does BRC have a financial affiliation with other programs?

No

Has the program ever operated under another name?

No

What is the structure of the program?

Theoretical framework is based on Risking Connection, The Restorative Approach, and Parenting with Love and Limits, which are all evidence-based trauma responsive models.

What is the average length of stay?

6 months

Who makes the determination whether a resident should be discharged?

The treatment Team, which includes psychiatrist, interdisciplinary staff, and parents.

Where do residents go after discharge? Home or another facility?

Home. We ask what prevents this child from living at home? What is required for the child to return home?That sets the foundation for the treatment plan.

How often can a resident communicate with parents?

A time each evening is set aside for calls to parents.

Is it monitored?

We do not listen to calls unless there is a physician order, which the parent will know about. This is extremely rare, and usually requested by the person who has full custody of the child. The staff dial the number, and the child is in sight of the staff. This is to prevent unauthorized access to the internet and calling unauthorized contacts. We have a waiver from the State Department of Human Rights that allows the legal guardian to determine who has access to their child. Friends are not included on the list.

What are the expectations of family involvement?

Parents are expected to participate as members of the treatment team. Family therapy occurs weekly, either in person or virtually.

How often are parents expected to participate in family therapy?

Weekly. The dates/times are scheduled with the therapist.

Is there other parent work expected or suggested?

From time to time, there may be family therapy assignments and books/articles to read.

Are siblings allowed/invited to participate in the process?

This is individualized. It can be decided with the Therapist.

How often will the program be communicating with the family?

Regularly scheduled contact can be scheduled with the therapist. Parents are notified when a child is ill, has an injury (even a scraped knee) or is involved in an incident.

What licensing or credentialing do the therapists have?

Therapists are master’s prepared professionals who are licensed as LCSW, LPC, or LMFT, CSAC, or who are working toward obtaining the required supervision hours to achieve licensure. Whether licensed or working toward licensure, every therapist receives individual and group supervision by a Licensed Professional and a Psychiatrist.

How does visitation work?

There are set times on the weekend for visitation, but visitation outside of those hours can be arranged with the resident’s therapist. We have many parents who come from out of town, so it is best to make arrangements with the therapist for extended times and TLOAs. Visits are opportunities to practice what has been discussed in family therapy.

Are communications monitored? i.e. Are letters opened and read before being distributed? Are emails read first? Is there a staff person in the room for phone calls?

Children do not have access to email. Mail is not monitored (read) except on the extremely rare occasion where a doctor’s order has been put in place. We do have the children open mail and packages in front of staff to show that there is nothing harmful in the envelope or package. A staff member is present in the room during calls.

Do you get to choose the people who your child communicates with?

Yes, we have a “list of approved contacts” on the dorm that the parents are asked to develop at time of admission. We ask that it be limited to family members and clergy. Often a parent who lives out of the country or in another State has family in the local area and the parent can add them to the contact, visit, and TLOA list. We will seek your permission each time before allowing that assigned person to take your child on a TLOA.

What is the amount/frequency the program will communicate with the family throughout the program? Who will be communicating with us?

At time of admission, you will be given a list of contacts and phone numbers. Your main contacts will be the Therapist, The Treatment Coordinator, and the Dorm Nurse. In addition, a school case manager will contact you monthly. The Program Clinical Director is also available if you cannot reach the therapist. That Clinical Director holds monthly group calls with parents for questions, training, and taking suggestions.

How does communication work internally? How often do they discuss each student? Who is involved in those discussions?

Internal communication seems constant because we have so many staff involved in each case. Reviews happen at shift change, during supervision 2-3x per week. Staffing is monthly and interdisciplinary clinical reviews are weekly. Behaviors and problems are reported to the therapist and Treatment Coordinator as they occur. Nurse and therapist report info as it occurs to the physician. Staff usually involved in internal communication may include the Residential Counselors, Treatment Coordinator, Therapist, Clinical Director, Residential Director, Teachers, Nursing staff, physician, dietary, rec therapy. Incidents are reported to and reviewed by the physician, Director of Nursing, COO and CEO. The Residential Director, Clinical Directors, DON, COO are available to staff around the clock.

What is their training? What is the average age? What does your program look for when hiring staff? The education level of staff? Are the employees’ contractors?

Direct care staff are employees who receive 3 weeks of preparatory training prior to being responsible for youth. In addition, ongoing clinical training is provided by our clinical staff in supervision and formal training sessions. Our preference is to hire staff who are mature enough to leave their ego at the door, staff with military experience, staff with college degrees, and staff who have previous experience working in Behavioral Healthcare. Basically, staff must be Nice, Competent, and Fun.

How is staff trained in terms of medication and first aid?

Licensed Nursing staff handle medication.

What is the ratio for:

  • Academic class sizes – teachers – 1:8
  • Direct care staff -students – 1:3
  • Therapist caseloads – 1:6

How often does the student meet with the individual therapist?

Individual therapy 2x per week in addition to PRN when indicated.

How often do we (the family) speak with the therapist or contact the program?

At least once per week. Can be scheduled more frequently. Call or email and if they are otherwise engaged, they will return the contact.

What other types of therapy do they have on a weekly basis?

A full rec therapy program. Kids revolve through the equine program, which is twice a week for 6 weeks. We have a therapy dog who visits each unit weekly.

What types of recreational therapies are offered and how often?

Equine program, Art, community outings, activities to build social skills and to improve executive functioning, Scouting.

What do you do if a student isn't connecting or working well with the assigned therapist?

We figure out why. It is most often a case of Transference, which is a common occurrence during treatment. A staff member will remind the child of a previous relationship and the child will treat the staff member as if they were in the previous relationship. Transference gives the opportunity for the child to identify past interpersonal conflicts and work through them. (“You hate me just like my stepmother does, you’re just like my father, you ignore me like my parents do, my parents always let me have my way, I hate you, my roommate gets more attention than I do, you NEVER listen to me, I hate you” and similar phrases are indications that transference is taking place. Our staff are trained to deal with this and help the child problem solve, gain some perspective and understand their responsibility in the conflict. Therapists must maintain an awareness of their own counter transference, not take things personally, and help the child talk about the previously perceived wounds. A “bad match” is very unusual with a well-trained therapist. But some therapists work better with certain types of kids or certain diagnoses. A change in therapist must be handled very carefully so it does not appear that the therapist is rejecting or giving up on a child. The new therapist helps the child identify the transference issue and helps them resolve the conflict.

How is movement or progress in the program measured?

The discharge criteria must be kept in mind. The job of the RTC is to prepare the child and family to make enough progress to function at home and continue treatment on an outpatient basis. Goals are steps toward achieving the discharge criteria. It is important that goals be measurable. Almost all goals fall into one of three categories: 1. be responsible (do the right thing); 2. be respectful (to self, others, property, society) and 3. be the kind of person that others want to be around. Goals are reviewed in staff meetings, supervisions, in staffings and in family meetings.

What are some diagnoses that make a child appropriate for your program?

We accept children with a wide range of mental health diagnoses, including higher functioning children on the autism spectrum. Children must be verbal and able to complete activities of daily living on their own. Other diagnoses include depression, anxiety, attachment disorder, bipolar disorder, PTSD and ADHD.

Do the students have grade-level classes or are they combined?

2-3 grades are often in same classroom.

Is the school accredited?

Licensed and accredited

Are teachers certified in their subject areas?

Yes

Are teachers available outside of class for help?

If tutoring is part of IIP. We do ask parents to understand the focus of our program is treatment, not academics.

Are teachers present during any of the study hall periods?

Don’t have study hall.

Is there a track for increased academic work?

Individualized plans are possible.

Do they read books? Novels, non-fiction?

Yes, books are available to residents.

Do they write essay or in a journal?

Yes, residents are welcome to write in a journal, but this is voluntary.

How do you ensure my child will stay on track with school?

We understand that school can be a huge stressor for many of our residents. We work closely with each child’s teachers and parents to find the best curriculum and setting to keep them on track. Our teachers work alongside other staff to ensure each child receives the attention and support needed to succeed academically.

Can they play sports?

Residents can play sports, but this is an informal activity.

Can they watch movies or sports games?

As monitored by staff

Do they have a gymnasium / pool?

Full gymnasium, outside basketball court, and field for sports. The Barry Robinson Center does not have a swimming pool.

Are off-campus activities in the community offered?

Yes

How are maladaptive behaviors managed?

We use the Restorative Approach (https://www.traumaticstressinstitute.org/trauma-informed-care-the-restorative-approach/)

Is isolation used other than for resident / staff safety?

Isolation is not used. We do not have isolation rooms.

Are medical restraints used? What medications?

No, If a child is in great emotional distress and cannot self-regulate after an extended period, the nurse will notify the psychiatrist, who may order 25-50mg of Benadryl. This happens about once or twice per year.

Who prescribes this medication?

Psychiatrist

Who administers this medication?

Licensed nurse

How is it administered, Orally or intramuscular?

Prefer orally, maybe IM.

Does the non-medical staff carry this medicine?

NO

If restraints are used, how often has this occurred in the last year?

18 physical holds during 21,000+ patient days. Restraint duration is under 2 minutes.

If suicidal thoughts or suicidal behaviors occur, what is the protocol in place to manage this?

Assessment by nurse or therapist, call to physician, who will give instructions. Instructions may include “close watch” where the child is within 3 feet of staff; or 1:1, where an additional staff comes in to watch that patient only.

If there is a psychiatrist involved, how often will they make assessments?

Therapists see patients daily and report the status to the physician.

Are psychiatrists staff or contracted? Is it one individual or a group of individuals?

The two psychiatrists are our employees.

Who consents for prescription medication adjustment and / or changes?

The legal guardian and child

Is it possible to meet with the psychiatrist in advance of beginning the program?

Typically, families do not meet with the psychiatrists before beginning the program. A psychiatrist reviews and approves each admission, and the therapist or admissions staff can arrange access to physicians.

What specific training in addiction medicine do psychiatrists or therapists have?

We do not have physician addiction specialists. We do not take children with a primary diagnosis of addiction. We do have a program managed by a CSAC (certified substance abuse counselor). It is called the 7 challenges program and was created specifically for people ages 15-25. www.sevenchallenges.com

Who administers the prescribed medications to the children?

Licensed nurses

Who is in possession of a child's prescribed medications?

Our contracted pharmacy has provided secure medication carts that are kept in locked medication rooms. Only nurses have keys.

Are the medications locked?

Double-locked; triple-locked for control drugs/medications.

Does the child self-administer the prescription medications?

No, the nurse administers all medications.

If it is staff who administer the medication, are they certified by a medication administration training program?

Licensed nurses administer medications.

What ability do staff have to provide over-the-counter medication for headache, stomach, etc.?

Licensed nurses provide over-the-counter medication based on physician’s order.

Who prescribes over-the-counter medication?

Physician

Do they give over the counter medications specifically for:

  • Cough / Cold: Yes
  • Headache: Yes
  • Diarrhea / Stomach Upset: Yes

Is parental consent required to the administration of over-the-counter medication?

Yes, consent is requested at time of admission for PRN over-the-counter meds.

Are any health parameters monitored experience: heart, lungs, blood pressure, weight?

It depends on the need. An H&P is required within 24 hours of admission unless one has been conducted within the past 30 days. We have a contract with a local pediatrician group to provide medical care. They come to the exam room in our infirmary. Every child is measured and weighed every month. EKGs are conducted if medication being prescribed recommends such. Labs are drawn per protocols set by the pharmacy and medical staff and conform with best practices. Vitals are checked when a child complains of feeling ill. Children who need specialized medical care are considered for admission on a case-by-case basis. We want to make sure we are completely prepared to provide proper care.

Are vaccines given if required during their stay?

We administer flu shots on campus. Vaccines are required and it is recommended that they be up to date prior to admission. If necessary, we can transport a child to the pediatrician office for necessary vaccines. If local, a parent can take them to their regular provider.

What dental care is provided?

The recommended exam every 6 months. We can arrange for dental care but prefer that the home dentist provides exams and care. For emergency needs, we will arrange for a trip to the dentist. Our staff can put the parent “in the room” via phone. PLEASE NOTE if a child is undergoing orthodontia care, we recommend that the home orthodontist see the child prior to admission with the understanding that they will not be back for another 6 months. It will require the home orthodontist to partner with a local orthodontist to provide follow up care. We have found that orthodontists will not agree to care for another orthodontist’s patient.

Understand the protocol for urgent or emergent medical treatment.

We have a pediatrician group who routinely visits to perform H&Ps and sick calls. They are also on call for us. We have an ER directly across the street at Sentara Leigh Hospital, and CHKD (local children’s hospital) is where they are transferred for care or necessary procedures. Parents/Guardians will be notified, and a staff member can use a cell phone to put the parent “in the room” with their child.

Protocol for emergent or urgent psychiatric treatment

If a child is experiencing an acute psychiatric crisis, we would take them to CHKD. CHKD does an assessment, and if it is determined that an acute unit is necessary, they will work with us to arrange that. Both BRC and CHKD will contact the parent. When a child is hospitalized, we still consider them “our” patient. We can provide bedside staff until the parent arrives and our case manager works with their case manager to coordinate care. In addition to medical beds, CHKD has their own psychiatric children and adolescent beds for acute care.

Where do children sleep?

In the dorms.

How many people are in a room?

All of our rooms are double rooms.

Does the staff monitor sleeping areas?

Yes. Staff are stationed within eyesight of all bedrooms, and document rounds every 15 minutes during sleep hours. Bedroom doors remain open.

Do they have an opportunity to eat any fresh fruit, vegetables, meat or fish products?

This is offered at every meal. We have a full-time registered dietitian who plans meals. A child from each dorm serves on the “menu committee” to meet with the dietitian and plan menus.

Are there separate areas for children with sexual-related mental health issues?

We do not take children who demonstrate sexually related behavior. This is not our area of expertise. We take children who may have suffered sexual abuse, but we do not have a proper setting or level of expertise to treat predatory behavior. Our team is happy to help families find other facilities that would be a better option for treatment.

Do all staff members including junior members have background checks and child abuse clearances?

Yes. This is required to work at all licensed children’s facilities. These checks are conducted by approved state and federal entities.

Can background checks and clearances be provided upon request?

We are not allowed to release or share these reports. But you can safely assume that every staff member at BRC has passed the Criminal Background Check (requires fingerprint) and the Child Abuse Registry. If a staff member has moved to Virginia from out of State, DSS runs a check on the Child Abuse Registry in that State. They cannot have any contact with children until those reports come back and are cleared.

Is there cognitive / educational assessment testing?

Yes. These assessments are done within 10 days of admission if the child is cooperative. We typically use the Woodcock Johnson. Cognitive testing is different than educational testing. Cognitive testing is usually included in the psychological report.

Is there a comprehensive psychiatric evaluation?

Yes, this is done at admission by the psychiatrist. This can be confused with Psychological Testing, which produces a report based on standard tests. It usually takes a few weeks for the child to settle in before they are tested, and then it takes up to 8 weeks to get the report. Psychological testing doesn’t “count” if it is conducted too frequently. The standard is every 2 years, but some testing may occur annually.

Please contact us to learn more about our services or to refer a youth in need