I worked on the adolescent side of the campus, the amount of pressure and paranoia placed on counselor assistants was ridiculous. They don't have a thorough written manual, there are constant emails about what new protocols are in place, then they're retracted days, weeks or months later. Often, one singular incident would result in unit-wide protocol change. Yearly reviews seemed to dig for one or two negative aspects throughout a year; not nearly enough praise for working double shifts, managing extremely difficult patients or entire communities or taking extra time to creatively implement ideas or tools that work in one situation. Also, as this is a private pay facility, too often clinical decisions where swayed by what management needed financially. Too often clinical judgement was thrown out the door and people not qualified to have as much say as they're given, called too many shots.