FAQ

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Admissions FAQ

Is PQ a Wilderness Program?

No.

PQ is a licensed accredited Residential Treatment Center (RTC).

 

The history:

PQ started in 20o4 as a alternative to the rugged survival/nomadic wilderness program. Students lived in gardens on the remote South Side of the Big Island.   From the beginning, we focused on working with youth who were largely internalizing their distress, and over the past 20+ years, PQ has evolved into a sophisticated licensed accredited RTC.

What is the cost of tuition?

There are two essential fees:

  • Enrollment Fee: $5500 (One time fee covers gear, academic credits, equipment, park fees and set up for entire stay)
  • Discounted Cash-pay Daily rate: $895
  • All fees are subject to state tax of 4.712%

We find that our residents’ stay depends on their age and therapeutic goals, and we work with each family to determine appropriate length of stay.  In general, residents are with us on average 12 weeks.  

Insurance:
PQ is out of network with all insurance providers, but we can and do bill your insurance. This can significantly offset the cost of treatment. For more information, see our Insurance Page

 

**The fees are largely all inclusive, but some individual services are billed separately.  Please contact our Admissions team 808-937-5806 or admissions@pacificquest.org for more information.

Why Hawaii?

How does PQ bill?

PQ is a family owned organization and we are not able to maintain unpaid balances beyond discharge. In general, we bill for just over a full length of stay and refund any unused tuition within 3 business days of discharge.

Check out our Example Billing & Fees Menu

Does PQ accept insurance?

While PQ is not in network with any insurance providers, many families are able to recover some portion of their stay through insurance reimbursement.  We work with several 3rd party billing partners who will work closely with our team and your insurance plan to submit pre-authorization, and pursue coverage.

 

A couple of important details to remember:

  • You’ll need to make payment in advance, and be reimbursed for covered days at the end of your stay.
  • It is extremely unlikely that even when treatment is authorized, will your plan cover an entire stay.  Most insurance will discontinue coverage around 30-45 days. 
  • Reimbursement is not a 1:1 for dollars but for days covered.  We bill families at a discounted cash pay rate and pursue higher negotiated rates with insurance providers to help offset costs.   

For more information please check out our Example Billing & Fees Menu

Is PQ accredited?

Yes. PQ is accredited through the following organizations:

  • CARF (Commission on Accreditation of Rehabilitation Facilities)
  • COGNIA (Academic Accreditation)
  • NMT (Neurosequential Model of Therapeutics)

 

Is PQ licensed?

Yes. All PQ facilities are licensed as Therapeutic Living Program through the Hawaii State Department of Health.

Some Important History:

Unlike other states where outdoor therapeutic programs operate (Utah, Georgia, North Carolina, Colorado, Oregon), the state of Hawaii does not have a licensing path available for outdoor based programs. As a result, PQ has been working closely with the Department of Health and other city/county/state governments since our inception in 2004 to become fully licensed. In the meantime, PQ has adhered to, and in many cases exceeded best practices, regulations and structure provided by known entities such as NATSAP, Hawaii State and County, and other governing bodies.

After years of working closely but fruitlessly with the state to develop a unique subcategory of licensing, it became clear that our best path forward was to pursue licensing in an established category and adapt our model/facilities accordingly.  To this end, PQ pivoted to pursuing a license in the Therapeutic Living Program (TLP) category. This license is offered by facility–not by organization–which requires a separate application and process for each of our facilities.

The Reed’s Bay campus in Hilo earned a TLP license in December 2016 and remains licensed to date.

After many attempts to bring our original Kau facilities into alignment for the TLP license, it became clear that the best path forward was to develop new facilities in an area with more established infrastructure.

  • January 2019 – PQ purchased a new set of facilities and spent several months developing them to meet the requirements of the TLP license.
  • June 2019  – PQ  moved into three residences  and continued the application process toward the TLP license for each one.
  • August 2019 – The Department of Health made an unannounced visit to two of the new homes. No health or safety violations were found.  
  • January 2020 – The Department of Health issued a Citation for operating an unlicensed Therapeutic Living Program. The citation laid out 3 options:
    • Discharge the students in those homes
    • Appeal the citation in court
    • Pay a fine, and reach a settlement
  • February 2020 – PQ reached a settlement with the state, paid a fine, agreed to complete the licensing process within two years, and not open new facilities until those licenses are complete. This settlement also allows us to continue operating in those facilities. At no time was PQ forced to close as a result of this licensing issue.
  • 2021–All new facilities licensed. 
How long is the program?

On average, residents are with us for approximately 10-12 weeks. 

Follow up question: Do you offer shorter/longer stays?

Sometimes; Check in with our Admissions team about your individual circumstances.

Does PQ offer financial assistance?

We are partners with a non-profit, Sky’s the Limit Fund, who provides grants to families that qualify. PQ then matches these grants. To date, this partnership has provided more than $650k in funding for families.  Give us a call and we can explore your options. 

Are all applicants accepted to PQ?

No. We have a multidisciplinary screening process to ensure we are working with families we feel confident we can help. For more information, please visit our Admissions Page.

What is the admissions process?

We highly recommend connecting with our admissions team to discuss your situation and learn more about the experience. The next step is typically filling out an application. In most cases we can review an application in 1-2 days. Once an application is approved, the next step involves completing the enrollment agreements, and finalizing travel arrangements. Learn more on our Admissions page.

How long does it take to review applications?

We do our best to review applications within 24-48 hours. In some cases where we need to connect with current or past providers, the review process may take a little longer.

Does PQ have any religious affiliations?

No. We welcome families and students from a wide range of faiths and spirituality.

When does PQ enroll new residents?

PQ enrolls new residents on a rolling basis. Provided we have availability, we can generally offer enrollment every day of the year and most any time of day.

How is PQ different than other programs?

Good news!
Chances are you are also considering a few other options for treatment.  Rest assured that there are many exceptional treatment options available to families and PQt is just one of them.  With a thoughtful and committed approach you won’t make a bad decision.

That being said, PQ is unique in a few key areas:

    • PQ is the only program that combines the hands on nature based experiences with the sophisticated clinical resources of a licensed and accredited Residential Treatment Center.
    • Outstanding nutrition and wellness programs.
    • Integrative psychiatry and daily onsite nurses.
    • The safety of 24/7 supervision
    • Exclusive focus on internalizing distress patterns
    • 7 therapy days per week
Are there onsite tours or visits?

No.

We’ve created a safe and private space for youth to explore difficult and sensitive issues. A regular stream of visitors would be disruptive to that environment. We do invite parents to join us for our 2-day parent intensive towards the end of treatment.

Does PQ enroll residents who are escorted?

Yes.

Most residents travel to PQ with a family member or by themselves. Occasionally a professional chaperone for our adolescent resident can be helpful to ensure a safe journey.  In all cases we require that residents are informed of their enrollment a minimum of 48 hours in advance of arrival. 

What do residents pack for PQ?

We provide clothing, toiletries, gear, supplies and nearly everything needed for a stay. We ask that students bring a supply of: 

    • Underwear/bras
    • Socks
    • 30-day supply of prescriptions
    • Rechargeable foil razor 
    • Handful of pictures to post in your bunks.
    • Comfortable, waterproof athletic shoes
    • Contacts/glasses
    • Retainer or any other medical devices
What about Reviews and Alumni Families?

There’s a wide range of online reviews available to families these days–everything from super scary and inaccurate accounts available on platforms like Reddit all the way to some mostly wonderful reviews available here: Google Reviews.  This isn’t of course the only metric families should use to make a decision, however we feel strongly that transparency is essential, and families should be prepared for all that they will find online.

Keep in mind that our programing and admissions criteria have evolved considerably over the past nearly two decades.  For the most up to date details about our programing, please connect with the admissions team.

 

Does PQ offer referral fees?

Absolutely not.

Furthermore, no one on our admissions team is commissioned, to remove any unnecessary incentives during the admissions process.

Is there a Book/Movie about PQ?

Sorta.

One alumni family felt so compelled about their daughters journey, they created a feature length award winning movie.  Girl On Edge.  Recently another alumni mother and daughter co-wrote a book outlining their journey:  The Krazy Girl (& Guy) Parent Survival Guide.

What about #BreakingCodeSilence?

 

The movement:

#BreakingCodeSilence is a movement dedicated to the reform and oversight of the “troubled teen industry.”  It’s a collection of past participants of various programs spanning decades who, for a number of reasons, reflect on their time in treatment programs as traumatic, damaging or otherwise abusive.  Recently this movement has been buoyed by the support of Paris Hilton, a past participant in various therapeutic programs.

Pacific Quest wholeheartedly supports the effort to reform the oversight and best practices of behavioral health treatment programs. PQ was founded on a belief that outdoor therapeutic programs could be safer, punishment free, and built on a principle of building youth up rather than breaking them down.  Since 2004 we’ve consistently refined and remodeled our approach to reflect best practices and provide positive safe experiences for our students and their families–over 3000 so far. 

#BreakingCodeSilence discussion boards are filled with serious allegations of abuse, neglect and unsafe practices in treatment centers, wilderness programs and schools–even some leveled against PQ. There have also been coordinated efforts to flood the web with negative reviews from individuals who’ve never been enrolled at PQ. Like most online movements, there is a tendency to focus attention on the most egregious and sensational content, and as a result misinformation has a way of finding its way to the surface.

For clarity, at Pacific Quest there have never been any:

  • Forced closures
  • Criminal investigations
  • Findings of abuse, assault, misconduct or neglect
  • Serious injuries or deaths

Improvement:

This misinformation however should not distract from the important conversation. While we dispute the handful of accusations made against PQ in these discussion boards and reviews, we also appreciate the importance of evolving our approach to caring for youth.  As a direct result of of this conversation, we have and continue to assess and revise many areas of our programing including: 

  • We no longer enroll students who are “escorted.” We do enroll students who are chaperoned but they must have at least 48hrs notice before traveling to PQ.
  • We’ve revamped our student grievance process to ensure there is a clear and transparent way to address individual concerns.
  • We’ve made an overhaul to our outfitting process, the quality of gear and the personal items/clothing students are allowed to bring.

We routinely assess our policies, procedures and facilities for transparency and safety. As part of our ongoing efforts to improve our experience and provide outstanding treatment, Pacific Quest is committed to participating in the Y-OQ research program, collects feedback from students and families through surveys.

Oversight:

Third party oversight is essential to safe effective operations.  Facilities and records are regularly (and randomly) inspected and reviewed by the Hawaii Department of Health as part of our Therapeutic Living Program License requirements. In addition to state oversight, Pacific Quest is also accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) which involves a rigorous, nearly year long review, of over one thousand criteria ranging from risk management, staff training, client centered care and organizational standards.

Reviews:

Increasingly, families depend on online reviews to make sound decisions on everything from hotel rooms to coffee makers.   Healthcare, and in particular mental healthcare, remains a difficult space to depend on reviews to make informed decisions. The stigma surrounding mental health means that many who benefit from this service are reluctant to share their journey even within their own communities, let alone in a public space like an online review. Fortunately this stigma is shifting, and new forums like Thriving Me Now are providing space for sharing and discussing meaningful and positive treatment experiences. We also encourage alumni to post a review when they are comfortable, and we proudly have over 100 Google reviews.

Clinical FAQ

What is PQ’s clinical model?

PQ utilizes a range of evidence based models. These include CBT, Trauma Informed Therapy, EMDR, Sandtray therapy, Family Systems Therapy, Motivational Interviewing, elements of DBT, and a host of relational and milieu based interventions. All of these modalities are incorporated through a developmental lens with the Neurosequential Model of Therapeutics (NMT). For more information, please see our page on NMT

How is trauma addressed?

In many cases, trauma is an underlying cause of the distress our residents arrive with.  The NeuroSequential Model of Therapeutics (NMT) is a clinical modality that is designed to address the developmental impact of youth who experience trauma. 

Does PQ work with adopted adolescents and young adults?

Frequently. In fact the NeuroSequential Model of Therapeutics (NMT) is specifically designed to address the developmental impacts of adoption.

Does PQ treat eating disorders?

No. We do however work frequently with adolescents and young adults who have a history of eating disorders or disordered eating patterns. In these cases, it’s essential that residents are physically safe (weight stable) to participate at PQ, and that they are able to continue to maintain adequate nutrition and hydration during their stay. To support these students we offer:

  • Weekly wellness checks with a RN
  • Meal completion supervision
  • Therapeutic support to address the root cause of the distress cycle.

PQ is not able to support students who are:

  • Significantly underweight
  • Actively restricting or purging
  • May require medical interventions such as a feeding tube

The opportunity to develop a healthy relationship with nutrition is a cornerstone to our seed-to-table experience.  It’s not about counting calories or control. We support feeling well by eating well. 

Does PQ treat primary substance abuse or dependence?

No. PQ is not a primary addiction or chemical dependency program. That said, some of our residents have turned to substances as a secondary coping skill–usually THC. Our approach to working with these substance abuse patterns is to focus on the underlying patterns of anxiety, depression, and trauma. We aim to build a cycle of insight, resiliency, and (where appropriate) a commitment to sobriety.

How much therapy do residents receive?

Therapy is available 7 days a week. In many cases, additional sessions are implemented as needed throughout the course of treatment based on your specific needs.

What is PQ’s success rate?

PQ is a designated research facility for the Youth Outcome Questionnaire. We closely track our alumni and outcomes. For more information, please visit our page on Outcomes.

What happens after PQ?

Every family is a little different. A big part of our job is to help students and their family discover a plan for discharge. Some families chose to explore out of home placements like boarding schools or transition programs. Many residents happily return directly home with the support of a transition plan in place.

Medical FAQ

How far is PQ from a hospital?

In nearly all cases, less than 30 minutes away from the nearest hospital.

How does PQ manage medications?

PQ has an integrative approach to psychiatric medication management. Our staff psychiatrists work closely with the home team, the family, the therapist and the team on the ground to craft a comprehensive treatment plan. For more information please review our Integrative Psychiatry page.

What other wellness services are offerred?

Every resident is offered a unique set of wellness/medical related resources including food sensitivity testing, lab work, pharmacogenetic testing, nutritional assessment/supplementation, acupuncture, integrative psychiatry and much more. For more information visit: Wellness.

Programs FAQ

What is the weather like in Hawaii?

PQ’s facilities are on the east (windward) side of the Big Island.  The island’s nearly 14,000ft Mauna Kea Mountain (often covered in snow during the winter months) catches the reliable trade winds along with their moisture to create a verdant tropical climate below in Hilo.  Temperatures are very consistent throughout the year, with average highs in the mid to low 80’s. A typical day starts with sun, followed by a mild tropical day rain which typically blows out by mid afternoon. Most nights are punctuated by heavy downpours. 

What about those huts?

Those are called “Hales.” Hale’s are a space in the garden to get out of the elements, store gear, meet with a therapist etc. No one ever sleeps there—its just your own personal space during the day.

How many residents are enrolled at PQ?

The Adolescent Program typically has between 10-15 residents.

The Young Adult Program has between 6 and 8.

How big is the campus?

Between all of our campuses we have just under 10 acres. For more information, visit our Location page.

How are residents who identify as LGBTQ+ supported?

PQ welcomes residents, families, and staff from all points of the rainbow. We offer gender based sleeping (Male & Female). By default residents are assigned to bunks based on their assigned sex at birth. On a case by case basis, when residents identify as a gender that is different from their assigned sex at birth, we can accommodate gender affirming bunk assignments.

We are committed to providing a safe and agenda free space for residents to explore their identity.

 

How many staff members does PQ have?

PQ has around 85 team members.

Are residents ever isolated/silenced?

No.

We have two programed down/quite times each day: lunch & the bunks at night for sleeping.  In all cases we have 24/7 awake staffing available to support and provide care.  Learn more on our Safety page.

How active are residents?

We are outside and engaged in nature all day every day plus at least one hour of structured exercise.  All activities can be modified to ensure they are accessible for all abilities and level of fitness.  For more information, please visit our page on a typical day for Adolescents and Young Adults.

Where do residents sleep?

Residents sleep indoors every night in shared bunk rooms of 4-8 residents at either our young adult home or the Reeds Bay Campus for Adolescents.  Here are some pictures:

 

How often do residents go to the ocean?

It depends. The Adolescent Program Program is based on the ocean and residents there on on the water almost every day.  The Young Adult Program is usually 2-3 times a week. For more information, visit our page on Experiential Learning.

How are residents kept safe?

PQ creates safety through:

Screening
Ensuring new residents are throughly vetted to understand their needs and that they fit our scope of practice.

Space
Creating an environment that is physically and emotionally safe.

Supervision
A diverse team of over 100 trained and experienced staff provide 24/7 attention to ensure the safety of our residents.

Largely because of these efforts, PQ has an impeccable safety record: No major injuries, no deaths, no lawsuits. For more information, please visit our page on Safety.

What about academics?

Academic credit is available to students in both our adolescent and young adult programs that have not yet completed high school. Pacific Quest students have the opportunity to complete seven academic courses for a total of 4 credits.

Courses include:

  • Career and Technical Education – Horticulture Pathway (0.5 credits)
  • Health Education – Health Education (0.5 credits)
  • Language Arts – English and Language Arts (0.5 credits)
  • Physical Education – Lifetime Fitness (1.0 credit)
  • Science – Environmental Literacy (0.5 credits)
  • Social Sciences – Hawaiian Culture (0.5 credits)
  • Electives – Psychology (0.5 credits)

For more information visit our page on Experiential Learning.

What do residents eat?

A robust diet is essential to feeling well inside and out. Residents at PQ enjoy a whole foods anti-inflammatory diet consisting of veggies, mixed proteins, fruit, and whole grains–much of which grown. For more information on a typical menu, visit our page on wellness.

What about technology?

We take a break from phones, internet and screens. With the exception of letter writing and weekly family video calls, it’s a technology free experience.

How are families involved in the program?

Family involvement is integral to a successful experience. Families are engaged through a caregiver manual, included in letter writing, weekly treatment planning calls, weekly photos, family therapy calls and a 2 day onsite parent program. For more information, visit our page on Families.

Is there Surfing?

No.

The PQ campuses are located on the East Side of the Big Island which does not have great access to beginner surf spots.   We do however retain a fleet of stand up paddle boards and are swimming, snorkeling, kayaking and enjoying the beauty of our ocean front Reeds Bay campus.

Careers FAQ

What are the requirements?

It depends on the position, but most jobs at PQ require a minimum of a bachelor’s degree and some experience in a related field. Clinical and wellness positions often require independent licensure and more extensive experience. All positions required drug screening, health assessment a 3rd party background screening and state required fingerprinting.

What positions are available?

Please visit the Careers page for more information.

How do I apply to work at PQ?

Please check out our current job listings and apply online. If you have any questions, we prefer you reach out to us at jobs@pacificquest.org.

Are internships available?

Sometimes. Reach out to jobs@pacificquest.org for information.