Psychiatric Quarterly [psaq] ph163-psaq-454354 November 26, 2002 12:29 Style ﬁle version June 4th, 2002
Psychiatric Quarterly, Vol. 74, No. 2, Summer 2003 (
CREATING SANCTUARY IN RESIDENTIAL
TREATMENT FOR YOUTH: FROM THE
“WELL-ORDERED ASYLUM” TO A
Robert Abramovitz, M.D. and Sandra L. Bloom, M.D.
This paper addresses the need for a coherent conceptual therapeutic approach
to guide work with disturbed children and adolescents in residential treat-
ment centers. The paper identiﬁes changes in the population currently in care;
examines the two dominant approaches that historically have shaped the stan-
dard treatment models used by most residential centers; and discusses four
longstanding debates that have complicated the development of a consistent
therapeutic approach for residential programs. It concludes with a description
of The Sanctuary
Model. Integrating a variety of treatment approaches, this
trauma-based systems approach to care was ﬁrst used with adult inpatients
traumatized as children. It is now being introduced by a major social agency
into three of its residential centers to provide a systematic treatment model for
use in their schools, living units, and treatment sessions.
KEY WORDS: residential treatment; trauma; children and adolescents; history; Sanc-
Robert Abramovitz, M.D., Chief Psychiatrist, and Director of the Center for Trauma
Program Innovation at the Jewish Board of Family and Children’s Services, New York,
Sandra L. Bloom, M.D., CEO, Community Works, Philadelphia, PA.
Address correspondence to Robert Abramovitz, M.D., Jewish Board of Family and Chil-
dren’s Services, 120 West 57th Street, New York, NY 10019; e-mail: firstname.lastname@example.org.
2003 Human Sciences Press, Inc.