Standards for public agencies

2020 Edition

Residential Treatment Services (PA-RTX) 9: Service Array

The residential treatment program utilizes residents’ interests, strengths, and needs to develop a wide array of structured, supportive, therapeutic services, and educational and vocational components that combine residential and community activities, as appropriate, and offers residents choice and flexibility.


Detoxification treatment programs should include daily clinical services such as appropriate medical care, therapy, and withdrawal support. A range of therapies (e.g., cognitive, behavioral, medical, and mental health therapies) should be provided to service recipients on an individual or group basis. Services should aim to enhance the service recipient's understanding of addiction, completion of withdrawal management, and referral to an appropriate level of care for substance use treatment. The delivery of services will vary and depends on the assessed needs of the service recipient and his or her treatment progress.
2020 Edition




Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behavior, improve functioning and well-being, and return to a stable living arrangement in the community.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Sample of activity schedules
  • Proof of accreditation, licensure, or certification for outside providers operating adventure-based activities
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Residents
  • Review case records
  • Observe the program

PA-RTX 9.01

A structured, interdisciplinary program appropriate to the age, developmental level, social and emotional needs, strengths, and interests of individual residents, includes:
  1. treatment for severe emotional disturbance or mental health and substance use conditions;
  2. individual and group counseling;
  3. frequent family therapy, unless contraindicated;
  4. educational and/or vocational programming;
  5. art, music, athletic, and other recreational opportunities and activities;
  6. legal advocacy, as appropriate;
  7. opportunities to participate in religious observances in a faith or spirituality of choice;
  8. community cultural enrichment;
  9. positive parenting techniques, as appropriate; and
  10. independent living preparation.


Some standards elements may not be applicable for crisis stabilization and short-term diagnostic programs due to length of stay and program design.

PA-RTX 9.02

Services provide predictability, structure, support, and a positive culture that includes:
  1. a written, individualized program for each resident;
  2. daily living experience to effect healthy behavior change; and
  3. advanced posting of schedules for structured and supervised activities.


Some standards elements may not be appropriate for crisis stabilization and short-term diagnostic programs due to length of stay and program design.


Agencies that are resident-guided empower, educate, and facilitate voice and choice of those served by the program. Offering residents decision-making power leads to more positive long-term outcomes. Agencies that are family-driven empower, educate, engage, and promote voice and choice of families.

PA-RTX 9.03

When planning milieu activities, the agency takes into account:
  1. developmental level and age;
  2. emotional stability;
  3. group characteristics;
  4. personality;
  5. skills and interests; and
  6. gender.

Fundamental Practice

PA-RTX 9.04

The agency evaluates residents for their ability to participate in athletic activities and obtains, as necessary:
  1. a written, signed permission slip from the resident’s legal guardian;
  2. a medical records release;
  3. a signed document from a qualified medical professional stating that the resident is physically capable of participating; or
  4. an adult waiver and release of liability.
NA The agency does not offer athletic activities to residents.

Fundamental Practice

PA-RTX 9.05

Agencies that purchase services from providers that operate adventure-based activities with a significant degree of risk request proof of accreditation, licensure, or certification with a nationally recognized authority for the activity being conducted.
NA The agency does not purchase services from providers that operate adventure-based activities.
Examples: Adventure-based activities with a significant degree of risk can include, white water rafting, climbing walls, or ropes courses.