[Statistical survey of tuberculosis patients on residential treatment in the northeast district of Japan].
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Female↗
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Results for “RESIDENTIAL TREATMENT”
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From residential treatment to adoption: a permanency planning service.
One agency's experience demonstrates how a commitment to permanency planning and use of a continuum-of-care model help achieve adoptive homes for children with special needs.
Adolescent↗
A family centered approach to residential treatment.
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Adolescent↗
The development of abused and high-risk infants in different treatment modalities: residential versus in-home care.
This paper outlines the Parental Stress Center (PSC) residential treatment program and its evaluation study, specifically focusing on the developmental status of infants in treatment. The Bayley scores for mental/motor development are given for a subgroup of 20 deprived infants admitted to the residential center and for two matched groups. One comparison group consisted of similarly deprived infants, the other of normal infants. The groups, tested three times, showed few differences either among the three groups at each time period or within each group over the three time periods. The most significant between-group difference was in motor scores at time 2, with both PSC infants and problem comparison infants scoring significantly below the normal comparison infants. The decline of motor scores of the PSC infants was probably attributable to the physical restrictions of the nursery. By the final testing at age 1, these scores had improved, and again there were no group differences. The results indicate that despite the use of multiple caregivers, the deprived infants admitted to residential care kept pace with similar babies in other treatment modalities. The overall high scores when compared to other research data indicate the decided worth of early intervention.
Child Abuse↗
Program variation in treatment outcomes among women in residential drug treatment.
Multilevel modeling was used to assess the program characteristics associated with treatment retention among 637 women in 16 residential drug treatment programs in the Drug Abuse Treatment Outcome Study. Women who were pregnant or had dependent children had higher rates of retention in programs in which there were higher percentages of other such women. Longer retention was associated with higher rates of posttreatment abstinence. Bivariate analyses showed that programs with higher proportions of pregnant and parenting women provided more services related to women's needs. The findings support the provision of specialized services and programs for women in order to improve outcomes of drug abuse treatment.
Adolescent↗
Outcome study: comparison of short-term vs long-term treatment in a residential community.
All patients admitted to a Residential Treatment Center (RTC), a drug-free hospital-based inpatient facility in February 1985 through July 1985, were followed-up 6 months after discharge. The results are contrasted with those obtained in 1973 in a similar follow-up study. Length of stay at RTC had been reduced from 1 year in 1973 to 3 months in 1985. Six months after discharge, the longer length of stay in 1973 appears to be almost twice as effective as the 3-month program in 1985.
Adolescent↗
Benefit-cost analysis of addiction treatment in Arkansas: specialty and standard residential programs for pregnant and parenting women.
A benefit-cost analysis of specialty residential treatment (Specialty) and standard residential treatment (Standard) was conducted on a sample of pregnant and parenting substance abusers from Arkansas. Economic benefits were derived from client self-reported information at treatment entry and at 6-month postdischarge with the use of an augmented version of the Addiction Severity Index (ASI). The average cost of treatment in Specialty programs was US dollars 8035 versus US dollars 1467 for Standard residential treatment. Average net benefits (benefit-cost ratios) were estimated to be US dollars 17144 (3.1) for Specialty and US dollars 8090 (6.5) for Standard. The main policy implication of this research is that investment in Specialty residential treatment for pregnant and parenting substance-abusing women appears to be economically justified, but future evaluations should analyze larger and more comparable samples to improve power and precision in the benefit-cost statistics.
Arkansas↗
The integration of tobacco dependence treatment and tobacco-free standards into residential addictions treatment in New Jersey.
New Jersey was the first state to implement a licensure standard for all residential addiction treatment programs to assess and treat tobacco dependence in the context of entirely tobacco-free facilities (including grounds). A program evaluation of the first year of the policy (2001-2002) assessed the impact on programs, clients, and staff. At 1-year follow-up, all 30 residential programs surveyed provided some tobacco dependence treatment and 50% had tobacco-free grounds. Eighty-five percent of the programs accepted the state's offer to provide free NRT, reaching more than 2,326 clients. Seventy-seven percent of all clients were smokers, and 65% of the smokers reported they wanted to stop or cut down tobacco use. Forty-one percent of the smokers reported that they did not use any tobacco during their entire residential stay. There was no increase in irregular discharges, or reduction in proportion of smokers among those entering residential treatment, compared with prior years. Licensure standards regulation can be an effective mechanism for increasing the quantity and quality of tobacco dependence treatment in residential addictions programs.
Adult↗
Impact of tobacco-free policy on recruitment and retention of adolescents in residential substance abuse treatment.
As residential treatment programs consider adopting smoke-free policies, treatment providers question whether such policies interfere with patient recruitment and retention. This study assesses the effect of a smoke-free policy on retention using a sample of 155 low-income, mainly minority youth, randomly assigned to two long-term adolescent residential programs at the New Jersey Substance Abuse Treatment Campus. One of these programs has a smoke-free policy, the other does not. Smoking rates are high for the sample. Eighty-five percent of those adolescents smoke, on average half a pack daily, and 39% smoke a pack or more daily. Differential dropout rates between programs for key time periods related to tobacco withdrawal were analyzed to assess the potential effect of smoking policy on retention. Differential dropout rates at the point of program assignment, in the first two days of residency (p = .43), and for the first two weeks of residency (p = .37) show no differences between programs. While analyses showed heavy smokers are more likely than others to leave treatment early, they were likely to leave from either program regardless of smoking policy. As well, verbal expressions of dissatisfaction with smoking policy did not result in drop outs. These results indicate that smoke-free policies have no detrimental effect on program retention.
Adolescent↗
Residential (inpatient) treatment compared with outpatient treatment for nicotine dependence.
OBJECTIVE: To compare smoking abstinence outcomes between smokers treated in a residential (inpatient) program and those treated in an outpatient program to determine if residential treatment was superior to outpatient treatment in smokers with moderate to severe nicotine dependence. PATIENTS AND METHODS: Patients treated in the residential nicotine dependence program at the Mayo Clinic, Rochester, Minn., between May 1, 1992, and January 31, 1996, were selected for this study. Each patient in the residential treatment group (n=146) was matched to 2 patients who received an outpatient nicotine dependence consultation by a trained counselor (n=292). Each patient was matched on age, sex, year seen, number of cigarettes smoked per day, longest previous abstinence, education, and marital status. Abstinence at 6 and 12 months was determined by self-report. For the purposes of analysis, each patient with missing outcome data was considered to be smoking. RESULTS: The 6-month abstinence rates for the residential group compared with the outpatient group were 45% and 26%, respectively (P<.001), and the 12-month abstinence rates were 45% and 23%, respectively (P<.001). After adjusting for matching variables that were not exactly matched (age, baseline number of cigarettes smoked per day, and longest previous abstinence) and the baseline variables, including education, age when started smoking, and degree of nicotine dependence, there was a significant effect of residential treatment on 6- and 12-month abstinence rates (P<.001). Odds ratio of 6-month abstinence in the residential group was 2.74 (95% confidence interval, 1.60-4.71; P<.001) and at 12 months was 3.03 (95% confidence interval, 1.74-5.27; P<.001). CONCLUSION: Residential treatment for tobacco dependence is superior to outpatient treatment in some smokers who are moderately to severely nicotine dependent.
Adult↗
Therapeutic communities for substance related disorder.
BACKGROUND: Therapeutic communities (TCs) are a popular treatment for the rehabilitation of drug users in the USA and Europe. OBJECTIVES: To determine the effectiveness of TC versus other treatments for substance dependents, and to investigate whether effectiveness is modified by client or treatment characteristics. SEARCH STRATEGY: We searched: Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2005); MEDLINE, EMBASE, Psycinfo, CINAHL, SIGLE from their inception to March 2004. Reference lists of studies were scanned. SELECTION CRITERIA: Randomised controlled trials comparing TC with other treatments, no treatment or another TC. DATA COLLECTION AND ANALYSIS: Two authors independently inspected abstracts, the methodological quality was assessed using Drug and Alcohol CRG checklist. When possible, data were summarised using relative risks and differences in means, otherwise results are presented as reported by authors. MAIN RESULTS: Seven studies were included. Differences between studies precluded any pooling of data, results are summarised for each trial individually: TC versus community residence: no significant differences for treatment completion; Residential versus day TC: attrition (first two weeks), and abstinence rates at six months significantly lower in the residential treatment group; Standard TC versus enhanced abbreviated TC: number of employed higher in standard TC RR 0.78 (95% CI 0.63, 0.96). Three months versus six months programme within modified TC, and six months versus 12 months programme within standard TC: completion rate higher in the three months programme and retention rate (40 days) significantly greater with the 12 months than 6 months programme. Two trials evaluated TCs within a prison setting: one reported significantly fewer re incarcerated 12 months after release from prison in the TC group compared with no treatment, RR 0.68 (95% CI 057, 0.81). In the other, people treated in prison with TC compared with Mental Health Treatment Programmes showed significantly fewer re incarcerations RR 0.28 (95% CI 0.13, 0.63), criminal activity 0.69 (95% CI 0.52, 0.93) and alcohol and drug offences 0.62 (95% CI 0.43, 0.90) 12 months after release from prison. AUTHORS' CONCLUSIONS: There is little evidence that TCs offer significant benefits in comparison with other residential treatment, or that one type of TC is better than another. Prison TC may be better than prison on it's own or Mental Health Treatment Programmes to prevent re-offending post-release for in-mates. However, methodological limitations of the studies may have introduced bias and firm conclusions cannot be drawn due to limitations of the existing evidence.
Humans↗
Using the DATCAP and ASI to estimate the costs and benefits of residential addiction treatment in the State of Washington.
Funding agencies and policy makers often criticize residential addiction treatment because the cost of residential services is typically higher than for outpatient services and it is unclear whether the outcomes are significantly better for most clients. To address these concerns, proponents of residential treatment require economic evidence to justify further investments in this modality over less intensive and less costly options. Recent studies have developed methods and empirical guidelines for using the drug abuse treatment cost analysis program (DATCAP) and the addiction severity index (ASI) in a comprehensive economic evaluation of addiction treatment. The present study applied these methods and guidelines to estimate the economic costs and benefits of residential addiction treatment at five programs in the State of Washington, USA that serve publicly funded clients. Program- and client-specific economic cost estimates were derived using data collected on-site with the DATCAP along with opportunity cost estimates associated with treatment attendance. Economic benefits were calculated from client self-reported information at treatment entry and at 6 months post discharge using the ASI. Outcome categories included inpatient services, employment, medical and psychiatric conditions, and criminal activity. Results indicate that average weekly economic cost of treatment services at the five programs ranged from 463 dollars to 703 dollars. Average (per client) economic cost of treatment was 4912 dollars (composed of 3650 dollars in program cost and 1262 dollars in client cost) for all subjects that completed both a baseline and follow-up questionnaire (N = 222; 82%). Average (per client) total economic benefit was 21,329 dollars, leading to estimates of 16,418 dollars for average net benefit and 4.34 for the benefit-cost ratio. Total and net economic benefits were significantly related to gender, race, religious preference, and baseline ASI composite scores for drug use and legal status. A detailed sensitivity analysis did not alter the qualitative findings. This study provides conclusive evidence that, for this sample of programs in Washington State, the economic benefits of residential addiction treatment significantly exceeded the economic costs. Although the results are not necessarily generalizable to private-paying clients or clients from other States in the US, the methods are based on widely used data collection instruments and well-accepted economic principles. Thus, extensions of this research to other clients, States, and modalities should be feasible and straightforward.
Adult↗
The clinical management of HIV-related dementia and other memory disorders in the residential drug treatment environment.
Human immunodeficiency virus (HIV)-related dementia and other memory and attention disorders are described in terms of etiology, incidence, and symptoms. Assessment for cognitive impairment includes basic screening (examples are given), or a thorough neuropsychological evaluation. Implications for treatment within the residential drug treatment environment include: (a) providing accurate information to staff and residents; (b) identifying residents' anticipatory anxiety; (c) supportive counseling of residents; (d) coaching residents in the use of coping strategies; (e) creating environmental support; and (f) frequent reassessment of treatment goals, including the appropriateness of independent living. Helpful concrete suggestions are listed.
AIDS Dementia Complex↗
Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility.
A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.
Adult↗
On-site HIV testing in residential drug treatment units: results of a nationwide survey.
OBJECTIVE: Residential drug treatment units are uniquely situated to provide HIV testing and counseling to their patients. This article examines the extent to which residential drug treatment units in the United States provide HIV testing on-site, and identifies organizational and institutional characteristics that differentiate units in which on-site HIV testing is available from those in which it is not. METHODS: The analyses use data collected in telephone interviews with unit managers from a random nationwide sample (N = 138) of residential drug treatment units in 2001. RESULTS: About half (48.6%) of the residential drug treatment units made HIV testing available to their patients on-site. Residential units were significantly more likely to make on-site testing available if they were larger (i.e., had a greater number of patients treated each month or had a greater number of staff that provided direct patient services) and if they were publicly rather than privately owned. Provision of on-site HIV testing was significantly correlated with having a medical orientation, i.e., with being operated by a hospital, with the unit viewing itself as patients' primary medical provider, or with providing medical care to the patients either on-site or at another part of the same treatment agency. CONCLUSION: In view of the critical importance of HIV testing for individuals who use illicit drugs and the existence of a simplified testing protocol involving saliva samples (eliminating the need for phlebotomy), units that do not have a medical orientation should be encouraged to make HIV testing available on-site.
Chi-Square Distribution↗
The cost of residential addiction treatment in public housing.
The cost of providing addiction treatment services in a variety of settings is useful information for program administrators, policy makers, and researchers. This study estimates the economic costs of providing substance abuse treatment services at Safeport, a three-phase residential treatment program focusing on addicted women living in public housing. Economic (opportunity) costs are estimated for each phase separately and for the complete program. Results indicate that the total cost of providing treatment services at Safeport in 2001 was $1,325,235. This total cost comprises $549,737 for stabilization or early abstinence (Phase I), $400,098 for relapse prevention and self-sufficiency (Phase II), and $375,400 for independent living preparation and long-term recovery (Phase III). Average daily census (number of clients/families on a typical day) was just over 11 clients/families in each phase or 34 clients/families for the entire program. The average length of stay in the three phases of the program was 12 weeks for Phase I, 20 weeks for Phase II, 18 weeks for Phase III, and 50 weeks overall. The average weekly cost per client amounted to $930 for Phase I, $677 for Phase II, $635 for Phase III, and $748 over the full program. The average cost per treatment episode amounted to $11,163 for Phase I, $13,541 for Phase II, $11,435 for Phase III, and $36,136 for the complete program. Future research should compare these cost estimates with corresponding outcome data from Safeport to perform a comprehensive economic evaluation.
Adult↗
A comparison of patients relapsing to addictive drug use with non-relapsing patients following residential addiction treatment in Antigua.
The outcome of a 29-day residential addiction treatment programme for persons from Antigua and Barbuda with addiction to drugs or alcohol was assessed. All 100 patients entering the drug and alcohol treatment programme at Crossroads Centre Antigua between November 1998 and October 2002 were included. All patients were assessed with regards to drug or alcohol use or abstinence in November 2002 using telephone and mail follow-up as well as informal follow-up with families and other community contacts. Crossroads Centre Antigua is a 35 bed, 29-day residential treatment centre for drug and alcohol addiction serving patients from developed countries (85%) and from the Caribbean region (15%). Patients records were also reviewed to obtain age, gender, ethnicity, drug of choice, years of problematic use, completion of the 29 day programme, family member participation at Crossroads Centre Antigua (a four-day programme) and acceptance of halfway house placement. Of the 100 Antiguan patients admitted, 46 (46%) were abstinent (non-relapsers) at average 20.7+/-14.7 months after treatment. Abstinence did not have to be continuous. Forty-nine were known to be using drug or alcohol (49%) and five (5%) were lost to follow-up and considered to be using drugs (relapsers). Age (37.5 vs 41.1 years), gender (28% vs 22% female), ethnicity (87% vs 87% Afro-Caribbean), years of harmful use (12.7 vs 12.5 years) did not differ significantly between relapsers and non-relapsers. Crack cocaine use (67% vs 65%) and alcohol use (26% vs 31%) as primary addiction did not differ significantly between relapsers and non-relapsers. Relapsers were significantly less likely to complete the 29- day programme (81% vs 100%, p < 0.01), have family members participate at Crossroads (32% vs 54%, p < 0.05) or accept halfway house placement (4% vs 54%, p < 0.001). In conclusion, abstinence was achieved in 46% of those entering treatment, in 51% completing treatment, in 60% whose families participated and in 92% of those accepting halfway house placement.
Adult↗
Sexual abuse, parental bonding, social support, and program retention for women in substance abuse treatment.
Residential programs that provide safe environments and child care can attract perinatal women into treatment. Other factors, however, may prevent some women from benefiting from these programs. Attachment theory suggests that one's early history determines the effectiveness with which one can utilize available social supports. Lower levels of program retention were predicted for women who had been sexually abused and for those who had poor early bonding. Eighty-four women in residential substance abuse treatment programs were studied. Clients who reported sexual abuse also reported lower parental care. Parental care and overprotection were inversely related, and related, in predicted directions, to perceptions of social supports. Sexual abuse alone was associated with time in treatment and the likelihood of graduation. Implications for developing effective counseling programs for women in substance abuse treatment are discussed.
Adolescent↗