Residential treatment is a common treatment modality for children and adolescents, and many youths have failed to improve while they were in residential treatment (Connor, Cunningham, & Melloni, 2002). In order to better understand why residential treatment has proven to be ineffective, this study examined the decision making processes of staff members in order to reveal factors affecting their application of treatment protocol in residential treatment. The Critical Decision Method (CDM) (Klein & MacGregor, 1988; Klein, 2002) was used to interview eight direct-care staff at a residential treatment program for adolescent boys with serious emotional and behavioral problems. A qualitative analysis of the interviews revealed that Klein's (2002) decision-making model could be adapted and applied to the decision-making processes of staff in a residential treatment setting.
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