The System of Care for Children and the Least Restrictive Alternative: Legal Origins and Current Concerns

Abstract

In this article we offer an account of the legal origins and current mandates associated with the least restrictive alternative (LRA), particularly as it applies to the system of care for children with severe emotional disturbances. Despite the inception of the LRA in adult mental health populations in the 1960s, confusion still exists about what treatment and placement settings are appropriate for children and adolescents. Prior investigations of the relation between restrictiveness of care and youth functioning have been inconclusive, but recent research including more points on the continuum of care for youth has been encouraging. Future research should further investigate the link between restrictiveness of treatment settings and youth functioning and should stress alternative treatment interventions that minimize restrictions placed on children.