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Psychiatric ResidentialTreatment Facility
A Different Kind ofTreatment FacilityGrafton’s Psychiatric Residential TreatmentCenter (PRTC), located just outside ofBerryville, provides intensive behavioralhealth treatment to children and youth. Ourgoal is to provide comprehensive caredesigned to quickly help youth develop theskills necessary to be successful in acommunity setting. Our clients have sufferedthe long-term effects of struggling with theirbehavioral health issues, often resulting in acomplex mix of trauma, difficulty withsocialization and educational challenges. Tohelp understand and navigate thesechallenges, we provide a trauma-informedmodel of residential treatment. The programis accredited by the Commission on theAccreditation of Rehabilitation Facilities(CARF).The RTC is secure and situated on 20 acres inrural Clarke County, VA. The propertyincludes a licensed and accredited school,multi-purpose gymnasium, basketball court,library, music program, art therapy room anda greenhouse that is an integral part of anactive horticulture program. In addition, thereare multiple opportunities for therapeuticexperiences with animals, for example,equestrian therapy.The RTC has twelve distinct units, each withprogramming designed to address thespecific needs of no more than nineindividuals for each unit. Individual roomsare available for each child served at theRTC. Treatment programming is optimizedto address the needs of the followingpopulations: Children and adolescents withpsychiatric disorders, including but notlimited to trauma-related disorders,attachment disorders, mood disorders,personality disorders and disturbance ofconduct. Treatment is also provided forsubstance abuse when it exists as aco-morbid condition. We view everydiagnosis from a neuro-behavioralperspective and focus uponskill-building and an approachcharacterized by comfort, not control.We also provide trauma-focusedrecovery programs for children of sexualabuse, trauma, exploitation andtrafficking. Children and adolescents withdevelopmental disabilities, includingintellectual disability, autism spectrum,communication disorders andco-morbid psychiatric conditions.
Our GoalPopulation ServedOur goal is to provide treatment with a sense of urgency sothat the child returns to the home and community asquickly as possible. Discharge planning begins on the dayof intake and we are committed to full family engagementto ensure a successful transition home.Berryville serves a broad spectrum of youth. Youth arealways served with other children who are of the sameage and experiencing similar challenges. The campusand professional infrastructure are subspecialized toaddress the specific needs of each group (boardcertified behavior analysts for autism spectrumdisorder and intellectual disabilities, therapists forpsychiatric disorders, etc.) All children are assigned apsychiatrist who oversees his or her multidisciplinarytreatment team.The diagnostic groups include:Grafton believes that a successful future for all children canbe ensured only by families, schools, and local and stateagencies working in partnership with one another. Werecognize that family involvement and engagement iscritical to improving the lives of children and in achievingsustainable positive outcomes. Parents are partners in theirchild’s treatment and drive decision-making. Family therapyis provided weekly and available in the evenings andweekends as well as during the workday.Our ProcessFor every client, an initial treatment plan is developedwithin 24 hours of admission to the RTC. During the firsttwo weeks of admission, assessments are completed todevelop a full conceptualization of the child’s and family’sneeds that includes input from the client’s transdisciplinaryteam: board certified psychiatrist, therapist, nurse, alliedtherapists, teacher, dietician, residential manager, casemanager, child and parent. In addition to residentialtreatment and special education services, we also provideindividual therapy, group therapy, family therapy andbehavior consultation for each child. In addition, a full rangeof medical and nursing support is available for each clientonsite. Our Medical Director integrates the physiological,physical, emotional and behavioral aspects of the individualto provide integrated health care. Additional services, suchas speech and language therapy, occupational therapy andpsychological assessments are provided based on clientneed. Children and adolescents with developmentaldisabilities, including intellectual disability, autismspectrum, communication disorders and specificlearning disorders coupled with a mental healthdiagnosis Children with psychiatric conditions, such asattachment disorders, mood disorders, thoughtdisorders and personality disorders Young males who have been sexually abused andhave sexually maladaptive behaviors as a result Victims of traumatic experiences, such as sextrafficking Treatment also available for substance abusedisorders when it is not the primary condition –Grafton does not provide detoxification servicesWhat age range do you admit? The RTC servesmales and females aged 6-22.What IQ range do you admit? Grafton has strongorganizational expertise in treating individuals withintellectual and developmental disabilities includingautism spectrum disorders. Grafton does not have anarbitrary IQ exclusion criterion. Instead, we follow aprocess prior to admission that will help us understandthe youth holistically.
Treatment Modalities &Interventions UsedGrafton employs a trauma-informed approach totreatment, which was internally developed and pioneeredmore than a decade ago. Our treatment approach involvesnot only understanding, recognizing and responding tothe effects of trauma, but also emphasizes the physical,psychological and emotional safety of our clients andemployees to rebuild a sense of empowerment. Once aclient is admitted to Grafton, he/she is assessed by aBoard Certified Psychiatrist and a conceptualization of thechild’s and family’s needs is developed by thetransdisciplinary team: psychiatrist, nurse, dietician,therapist, allied therapist, teacher, case manager, child,parent and others as needed. Grafton also provides clientsopportunities to access music instruction, art activities,animal-assisted intervention and organized sportsactivities. An individualized treatment plan – combiningone-on-one and group therapy as well as therapeuticactivities – is created for each client. A greenhouse is anintegral part of an active horticulture program and clientssell produce and flowers to a local farmers’ market.Clinicians at Grafton have training and expertise in a widearray of methodologies including trauma-focusedcognitive behavioral therapy, structural family therapy,applied behavior analysis, motivational interviewing anddialectical behavioral therapy amongst others. We alsoemploy therapists experienced in substance abusetreatment (Certified Addictions Therapist) and sexualtrauma and abuse recovery (Certified Sexual OffenderTreatment Provider).Within the Sexual Trauma and Abuse Recovery (STAR)program, we employ Trauma-Focused CognitiveBehavioral Therapy (TF-CBT). TF-CBT is anevidence-based treatment approach to help children andtheir caregivers address trauma-related symptoms. Corecomponents of TF-CBT are psycho-education about childsexual abuse and PTSD; affective modulation skills;individualized stress-management skills; an introduction tothe cognitive triad (relationships between thoughts,feelings and behaviors); creating a trauma narrative (agradual exposure intervention wherein children describeincreasingly distressing details of their sexualabuse);cognitive processing; safety skills and educationabout healthy sexuality; and a parental treatmentcomponent.For children with intellectual disabilities, we offer boardcertified behavior analysts who focus on antecedent andreinforcement-based strategies to improve skill acquisitionin the areas of communication, social interactions, motorcontrol and activities of daily living. The psychiatricresidential treatment facility in Berryville is a secure facilityand has a 12-foot fence that surrounds the property.Additional features at the RTC include a DVR camerasystem, alarms, campus-wide communication andhardware security.We provide ongoing training to our direct supportprofessionals in the areas of trauma-informed care, thefunction and meaning of behaviors, behavioralassessments and interventions and the importance ofcomfort versus control in supporting clients who areexperiencing behavioral challenges.
A Trauma-InformedApproachGrafton’s philosophy is one of comfort versuscontrol. We recognize that clients with intellectualdisabilities or mental health challenges willinevitably face frustrating circumstances on a dailybasis; these situations do not have to be artificiallyconstructed. Rather than seeking to control thestudent through manipulation or coercion, wemonitor behavior in a natural setting. In this way,we are not forcing potentially traumatizingcircumstances on the student, but are able toprovide appropriate support when obstacles ariseduring the school day with other organizations.Monitoring, Measuringand Mastering GoalsGrafton has successfully implemented a formalgoal-mastery initiative that seeks to assureobjectives established for each individual are clearlydefined, meaningful and measurable. And whatthat means can look very different for each clientwe serve.PROVEN SUCCESSMinimizing Restraint and EliminatingSeclusionWell over a decade ago, Grafton implemented anorganization-wide initiative to minimize and eliminatethe use of coercive techniques, such as restraint andseclusion. Today, not only have we achieved a 99.8%reduction in the use of restraint and 100% reductionin the use of seclusion, we have dramatically reducedthe number of injuries to clients and staff andsignificantly increased the rate of treatment goalsmastered across the organization. Through our UkeruSystems division (www.ukerusystems.com) —currently used in nearly 30 states and more than 130private day and residential programs, private andpublic schools, psychiatric hospitals and forensicunits — Grafton now shares this expertise with otherorganizations.100%80%60%40%20%Whereas grade level advancement may be anappropriate goal for one client, such advancementmay not be reasonable for another. At Grafton, wework closely with each individual and family toidentify goals that are appropriately ambitious,based on his or her unique abilities andcircumstances.Once set, data for each goal are graphed andformal systems put in place for review. Changes aremade, as the need indicates, to treatment andinstructional strategies. Since Grafton’sgoal-mastery initiative was implemented, Graftonhas consistently achieved a high rate of goalmastery as depicted in the graph to the right.0%2005200620072008200920102011 201220132014 2015201620172018"In public school, [my son]was spending as much asfour hours out of asix-hour day inseclusion.I asked howmuch time was spent inseclusion at Grafton. Theanswer? None."- Grafton Parent
RecognitionAccreditationGrafton’s minimization of restraintsinitiative has been recognized by:Grafton’s specialized therapeuticcommunity living options areaccredited by:For more information on Grafton’stherapeutic day schools, see contactinformation below.Contact:Email: admissions@grafton.orgPhone: 888-955-5205 x6460, x6461or x7327Fax: 540-542-1721LicensingGrafton’s therapeutic communityliving options are licensed by:Corporate Address:P.O. Box 2500Winchester, VA 22604www.grafton.org
Grafton's Psychiatric Residential Treatment Center (PRTC), located just outside of Berryville, provides intensive behavioral health treatment to children and youth. Our goal is to provide comprehensive care designed to quickly help youth develop the skills necessary to be successful in a community setting. Our clients have suffered
