2022 Edition

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

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


Withdrawal management programs should include daily clinical services such as appropriate medical care, therapy, and withdrawal support. A range of therapies (e.g., cognitive, behavioural, 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.




Residential Treatment Services provide individualized therapeutic interventions and a range of services, including education for residents to increase productive and pro-social behaviour, improve functioning and well-being, and return to a stable living arrangement in the community.
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Sample of activity schedules
  • Procedures for obtaining clearance to participate in athletic activities
  • 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


CA-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 counselling;
  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.


CA-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 behaviour 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.


Organizations 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. Organizations that are family-driven empower, educate, engage, and promote voice and choice of families.


CA-RTX 9.03

When planning milieu activities, the organization 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

CA-RTX 9.04

The organization evaluates residents for their ability to participate in athletic activities and obtains:
  1. a medical records release;
  2. a signed document from a qualified medical professional stating that the resident is physically capable of participating; and/or
  3. an adult waiver and release of liability.
NA The organization does not offer athletic activities to residents.

Fundamental Practice

CA-RTX 9.05

Organizations 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 organization 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.