Investigating ethnic prejudice among boys in residential treatment.
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Ensuring effective service delivery by direct-care personnel in institutional living units for persons with developmental disabilities historically has been a difficult process, despite considerable attention from researchers, service providers, and governmental regulatory agencies. In this investigation, we conducted a normative evaluation of the extent and quality of treatment services currently provided in residential living units and evaluated a comprehensive management system designed to improve such services. Results of the first experiment, encompassing 22 living units in three states, indicated that on the average two thirds of observed resident behavior did not involve any therapeutic activity. The results also provided social validity for the criteria used to evaluate the quality of treatment provision based on opinions of mental retardation professionals. Results of the second experiment indicated that a behavioral management program implemented during 23 separate time periods across five living units was accompanied by consistent and durable decreases in resident nontherapeutic activity as well as increases in specifically designated habilitative activity. The results provide support for the successful incorporation of behavioral management technology into human service settings on a large-scale, long-term basis.
As residential group care has become a less exclusively milieu-based therapy and more a "tapestry of therapies" that involves individual, group, and family therapy, psychopharmacology, intensive case management, special education services, therapeutic recreational activities, and a residential milieu based on therapeutic principles, the practice of providing detailed descriptions of the type of treatment has deteriorated. One might argue, however, that the need for their provision has become ever more important as the calls for improving the scientific quality of the outcome research have become more strident. This is especially true of detailed descriptions of the therapeutic underpinnings involved in the creation and maintenance of a therapeutic residential environment. As Trieschman and his colleagues discussed, a therapeutic residential environment is a place in which residents spend most of their time and have many potentially therapeutic interactions with peers and direct-care staff members.
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Specialists in childhood diabetes in North America were queried about the need for residential facilities for their patients with recurrent hospitalizations and school deficits due to family coping problems. Of 132 respondents, 115 indicated a need for 5-12% of their patients, a total of 530, close to the estimate of 600 based on the number of places available for Danish, Dutch, and German children.
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