Boys Town has changed a bit since the founding days when it was a place for street kids from Omaha- for one thing, it has had girls since 1975. The focus has changed, from a youth-leadership development model to a Family Home Model, in which the unit is a household of 8 kids (single gender) and a set of house parents (usually a married couple, it seems), living is a large brick house on the campus. But, in addition to that, Boys Town now provides In-Home Services within Nebraska, an Intensive Residential Treatment milieu on the campus (4 kids with more staff to monitor and manage troubled behaviors) and the ICTU at the University of Nebraska Medical Center, a locked unit. Oh, and a lot of traditional outpatient therapy. A kid could theoretically go up and down this continuum of care as ones mental illness required it, getting consistent behavior management throughout, and minimizing that sense of shock and transititon that so complicates things for a lot of SED kids.
In talking to one of the therapists, however, I learned that this model seldom works; their managed care "carve-out" provider sees the different levels of care as interchangeable parts, and that, despite having a system that would allow communication and relationship building between agencies as well as with children and families, kids are moved between agencies in such a way as to make it really hard to maintain continuity. It seems that it is never easy to make systems do what they should.
The transition program is, of course, magnificent; they hope to hae a manuel of transition training that we can all use soon. And steak in Omaha just tastes better. I recommend 36 hours in Omaha, if you ever have the chance.