Accreditation is the catalyst for continuous quality improvement
As part of a blog series to celebrate CARF International’s 60th anniversary in 2026, the blog editor interviewed CARF’s Managing Director of Child and Youth Services, Theresa Lindberg. Child and Youth Services (CYS) represents about 14% of CARF International’s accreditation business. CARF offers accreditation for 27 CYS programs/services and 5 specialty designations. In total, CARF provides accreditation in seven health and human services areas.
Q: How did you learn about CARF?
A: Before transitioning to CARF, I spent time in both the corporate and nonprofit sectors. I began my career in the corporate world, where I focused on training as well as performance measurement and management, and earned my Lean Six Sigma Green Belt certification in process improvement. I then moved into the behavioral health and human services field, working for a community mental health provider.
When I was ready for my next professional challenge, a close friend who worked for CARF introduced me to the organization, presenting an opportunity to combine my passion for human services with my background in performance improvement and quality. CARF’s core mission—supporting organizations through accreditation to deliver the highest quality services—is what truly inspired and drew me to this work. Partnering with dedicated groups that share a deep commitment to continuous improvement is what motivates me.
Q: How did your work as a resource specialist help prepare you for this role?
A: As a resource specialist for CARF, you work with organizations in various regions, and that helped me gain firsthand insight into the challenges, emerging trends, and innovative practices shaping the field. A key part of the role was serving as a conduit between the organizations, other stakeholders, and CARF leadership; identifying important developments; and communicating those insights to the managing directors.
That experience was really helpful in the transition to the managing director role because I already had a good knowledge base about regional trends and industry issues in the field, so I could then focus on expanding that to a national and global level perspective.
Q: What is your favorite part about meeting people at conferences?
A: When I represent CARF at conferences, I love when someone from an organization comes up and tells me that their programs have been accredited for 9, 12, 15 years, or more. I congratulate them and enjoy hearing about their experiences. I’ll often ask them if they have a CARF surveyor as part of their staff. One of the requirements to become a surveyor is that they work at a CARF-accredited organization.
Being a CARF surveyor is such a great benefit for personal and professional development, and at the organizational level, it is very helpful to have that kind of in-house resource. Additionally, surveyors get to be collaborative peer reviewers with other organizations and bring those experiences and learnings back to their organization.
Q: You are an instructor for our CARF 101 trainings to help attendees learn about achieving and maintaining accreditation. Tell us more about that and who should attend.
A: I love teaching the 101s because there are a variety of individuals that attend. I just taught a session in Ohio where there was someone who had been in my Nashville session the year before. Her organization sends her every year to get in-person updates on the standards.
The course is either for organizations new to accreditation or those looking for a refresher. Sometimes, attendees may be new to their organization or have a new role that has more involvement in the accreditation process.
Typically, there is a mix of new and seasoned people, so I like to encourage interaction between the attendees so they all learn from each other. I really emphasize that accreditation is not an event; it is a process, a journey. The organizations that really get the meaning and purpose of accreditation are the ones that have the standards and concepts embedded in their day-to-day activities.
The other thing I focus on is that the standards are not prescriptive. It can throw organizations off sometimes because they want to be told exactly what something should be like or is supposed to look like. We have those discussions and talk about what a surveyor might want to see or ask for when they are looking for evidence of conformance to the standards. I help attendees take the next step and think about what it looks like from an implementation viewpoint and from a demonstrating conformance perspective. Accreditation is ultimately about enhancing the lives of the people you serve—the children, the youth, and the families.
Q: What do you have planned for the 2027 standards manual?
A: For the 2027 Child and Youth Services Standards Manual, we recently convened an International Standards Advisory Council (ISAC) to develop new standards for Behavior Analytic Services. The standards will support organizations delivering behavior analytic services to children, adolescents, and adults with autism spectrum disorder, intellectual and developmental disabilities, and other individuals who can benefit from these services.
Standards for Support and Facilitation will also be updated based on feedback from our International Advisory Council and CYS organizations and surveyors.
Q: What trends do you see coming in the CYS field?
A: I am seeing more attention being placed on prevention, community-based, and home visiting programs and services. At CARF, we have been thinking about how we can support organizations that are expanding into those areas in a meaningful way with standards that reflect a child, youth, and family perspective. We are asking ourselves: how does that look from a continuous quality improvement perspective and support meaningful outcomes?
Some other things are how workforce development includes staff well-being and staff retention. Organizations are getting very creative with how they are supporting and taking care of their staff so they are able to continually and consistently provide high-quality services to children, youth, and families.
Q: In your opinion, why is accreditation important?
A: CYS accreditation creates a solid foundation—a framework for excellence, for continuous quality improvement, sustainability, long-term quality, accountability, and a focus on outcomes. Achieving accreditation demonstrates that an organization is committed to being effective in those areas and that it is dedicated to always improving and being open to feedback.
Accreditation is most valuable when it moves beyond compliance and becomes part of how an organization leads, learns, and improves. Ultimately, accreditation’s greatest impact is not on the organization itself, but on the lives of the people it serves and the quality outcomes it helps make possible.
I see tremendous passion and innovation in child and youth services organizations. They respond to the increasingly complex needs of children and youth, families, funders, regulators, and referral sources. CYS organizations operate in a complex environment that requires coordination among families, schools, juvenile justice systems, and other partners, often with competing priorities. Successfully balancing these relationships while keeping children, youth, and families at the forefront of decision-making is both a challenge and a critical part of their work.
Accreditation is the catalyst for helping them learn, collaborate, and embody the mindset of continuous quality improvement to know they are doing the very best for the children, youth, and families served.
Managing Director of Child and Youth Services
Theresa Lindberg, MSC, LPC, Managing Director of Child & Youth Services, joined CARF in 2021 as a resource specialist and was promoted to managing director in August 2024. She has more than 13 years’ experience as a licensed professional counselor in the mental health and child welfare fields and has had multiple roles supporting community mental health services and partnerships for children, youth, young adults, and families in Southern Arizona. Theresa holds two master of science degrees in counseling/community counseling and organizational management, both from the University of Phoenix, and a bachelor’s degree in arts and family studies from the University of Arizona.
