SEARCH · PubMed Health

Results for “RESIDENTIAL TREATMENT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources

PubMedDate not supplied

Case management services for adolescent substance abusers: a program description.

A case management model for adolescent substance abusers whose problems are severe enough to warrant residential treatment is presented, based on the experience of a demonstration project. The five integral functions of case management (assessment, planning, linking, advocacy, and support) are described within the framework of each phase of an adolescent's treatment program (screening, residential treatment, and continuing care). Detailed descriptions of case management activities and the philosophy underlying case management are addressed. The integrated client tracking and program evaluation monitoring system developed for the case management project is described, and evaluation data are presented. Among the advantages case managers are able to offer to the entire treatment process include encouragement of family involvement in the youth's recovery; providing support; tracking substance abuse relapse episodes following treatment; connecting the youth with school, work, and community resources; and helping youth to fulfill legal obligations.

Adolescent↗

PubMed1997

A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program.

This study compared 96 HIV-Positive (HIV+) and 357 HIV-Negative (HIV-) crack users who were participating in the same drug-free, residential treatment program. Comparisons were made on sociodemographic, health, criminal justice, psychosocial, and recovery motivation variables. As predicted, the HIV(+) participants were more apt than the HIV(-) participants to be female and recently homeless. Also as predicted, HIV(+) participants had poorer subjective health, had more convictions for various criminal offenses, and were less apt to acquire employment during treatment when compared to the HIV(-) participants. Contrary to prediction, HIV(+) participants reported more social support, were not less committed to abstinence or 12-step groups, and were not less apt to complete the treatment program in comparison to the HIV(-) participants. These results suggest that HIV(+) crack users can be successfully treated in a rigorous treatment program. Future research should examine post-treatment outcomes among HIV-infected persons.

Adult↗

PubMed1996

Treatment retention in women's residential chemical dependency treatment: the effect of admission with children.

In the United States there has been an increased interest in the development of treatment programs that admit chemically dependent women with their children. The Salvation Army Family Treatment Services in Honolulu, Hawaii has had a long history of admitting women both with and without their children to long-term residential treatment. This has provided an opportunity to study the differences in treatment retention between these two groups. Subjects were 130 females who participated in treatment between 1988 and 1993. Analyses were conducted to determine whether there were different outcomes for women with children in treatment and women without children in treatment, with regard to type of discharge and length of time in treatment. Results were significant and clearly indicated better retention rates for women who participated in treatment with their children.

Adolescent↗

PubMed2002

Residential psychiatric treatment of emotionally disturbed deaf youth.

A survey of the literature on emotional disturbance in deaf youth is followed by presentation of data on a sample of 58 deaf children and adolescents who were patients at the Tampa Bay Academy, a residential treatment facility serving both hearing and deaf youth with serious psychological disturbances. These 58 patients were compared to a hearing sample of 168 patients on key variables such as admitting symptoms, diagnoses, substance abuse, aggressive and assaultive behaviors, and sexual abuse. A startling and significant finding was that all of the deaf children admitted at age 12 years or younger had strong or confirmed indications of sexual abuse. Deaf adolescents had an 85% rate of strong or confirmed indications of sexual abuse. A list and brief description of residential care facilities serving deaf youth in the United States and Canada is reviewed. Only 8 were found that provided specialized services to deaf youth. Of those 8, only the National Deaf Academy, Mount Dora, FL, provided exclusive mental health and residential care to deaf persons.

Adolescent↗

PubMed2004

Smoking stage of change is associated with retention in a smoke-free residential drug treatment program for women.

Prochaska and DiClemente's Transtheoretical Model predicts dropout from substance-abuse treatment. However, it is not known whether readiness to quit smoking is associated with attrition from drug treatment programs with smoking restrictions. This study examined the relationship between smoking characteristics, smoking stage of change, and both length of stay (LOS) and discharge type among 75 perinatal substance abusers attending a smoke-free residential treatment program. URICA scores predicted LOS (P=.0004) and discharge type (P=.01). Women in action and maintenance remained in treatment longer and were more likely to complete treatment compared to those in precontemplation. Findings were not accounted for by addiction severity. Women with little interest in quitting smoking may have difficulty adhering to smoking restrictions during treatment for other drug problems, resulting in increased attrition. Alternatively, smoking stage of change may be a "proxy" for overall readiness to change in this population.

Adolescent↗

PubMed1995

Assessing the value of a short-term residential drug treatment program for homeless men.

Cocaine and other substance abuse has been found to be a contributing or primary cause of homelessness in urban men. This project evaluated the effectiveness of the Grant Street Partnership (GSP), a shelter-based treatment program for homeless, cocaine-abusing men, consisting of 90 days of residential treatment and 6 months of aftercare. We tested the hypothesis that the 182 men randomized to the GSP group, as compared to the 112 men randomized to a "usual services" group, would show significantly greater improvement over time in the areas of drug use and residential and economic stability. An 80% response rate was achieved overall for the five follow-up points. Cocaine use, defined as use of cocaine at least once in the prior 30 days, declined from about 90% at baseline for both groups to 11% in the GSP group and 55% in the control group at 21 months. The GSP group was also more likely than the usual services group to have achieved residential stability by the time of the 9 month follow-up. Neither group experienced an improvement over time in employment status.

Adult↗

PubMed1998

Depression screening scores during residential drug treatment and risk of drug use after discharge.

Depression is a highly prevalent disorder among patients in residential drug treatment, and the prognosis for recovery from chemical dependency among depressed persons is uncertain. This report presents one-year follow-up data on alcohol, cocaine, and marijuana use among patients who completed the Center for Epidemiologic Studies Depression Scale (CES-D) during their inpatient stay in one of 12 residential treatment programs in the Midwest. At 12-month follow-up, CES-D scores in the depressed range were significantly associated with risk of relapse for alcohol and marijuana use, but not for cocaine use.

Adult↗

PubMed2002

Unit cost of counseling and patients length of stay in a residential drug treatment setting.

BACKGROUND: Many published reports on cost of counseling give a fixed cost per hour of service. These estimates may be flawed. AIMS OF THE STUDY: The purpose of this study is to show, by way of an example, how cost of an hour of counseling depends on the nature of the patient, in general, and length of the patient s stay, in particular. Even though the health care professional provides the same hour of work, the cost of the hour is different for short-stay and long-stay patients. METHODS: We identified 5-short and 5 long stay patients in a residential treatment program. For each group, we asked the counselors to review the medical records and measure the patients utilization of various service units. We estimated the cost of a unit of service by dividing cost of an average patient by the program utilization of short and long-stay patients. RESULTS: The cost of an hour of counseling for long stay patients was 2/3 less than the cost of short-stay patients. Similar large changes in unit cost of treatment were observed for cost of group counseling or other components of substance abuse treatment. DISCUSSION: Our data was limited to one case study and may not indicate similar patterns in other treatment programs. The paper suggests that methods of studying cost of treatment should be adjusted to reflect case mix of patients and their expected length of stay. IMPLICATIONS FOR HEALTH POLICIES: Our analysis shows that higher rates should be set for patients at risk for short stays; conversely lower rates should be set for patients likely to complete treatment. Without adjusting the rate for the case mix of patients, health care institutions have an incentive to avoid the difficult cases and concentrate on long stay cases. IMPLICATIONS FOR FURTHER RESEARCH: A number of instruments that measure severity of illness or difficulty of treatment can be used to anticipate patients length of stay. Then the rate for units of treatment can be set based on patients expected length of stay. This paper presents a questionnaire that can be used to collect cost data and estimate cost per unit of treatment adjusted for expected length of stay.

Counseling↗

PubMed2003

Posttreatment victimization and violence among adolescents following residential drug treatment.

This article examines the relationships among experiences of childhood abuse, psychiatric disorders, self-reported victimization, and violent behavior, with a focus on gender differences. Data were obtained from treatment entry and 5-year post-treatment interviews of 446 adolescent clients in therapeutic community (TC) drug treatment programs throughout the United States and Canada. Fifty-eight percent of the sample indicated that they engaged in serious violent behaviors (e.g., beatings, threatening or using weapons against other people, or violent crimes such as assaults, rapes, murders) in the 5 years following their separation from TC treatment. Multivariate logistic regression analyses revealed that victimization in the posttreatment period was the most significant factor associated with violent behavior, and pretreatment childhood abuse experiences and psychiatric disorders were not significantly related to the odds of violent behavior. There were significant gender differences in self-reported victimization and violent behavior. The findings suggest that violence in young adulthood for males is related to increasing involvement in violent lifestyles that include drug trafficking, while violence among females is associated with the social and psychological consequences of drug involvement and victimization. High rates of violent involvement and victimization among former adolescent clients suggests the utility of incorporating interventions such as safety-oriented strategies for females or interventions that address involvement in the drug use lifestyles (i.e., use and dealing) for both males and females into residential treatment to reduce the likelihood of future violence.

Adolescent↗

PubMed2001

Federal prison residential drug treatment reduces substance use and arrests after release.

OBJECTIVE: The effectiveness of federal prison-based residential drug and alcohol treatment programs was evaluated using event history procedures that addressed the problem of selection bias and included a wide range of control variables. METHODS: The sample comprised 760 treatment subjects and 809 comparison subjects. Treatment subjects were from 20 different prisons of medium, low, and minimum security levels. Comparison subjects were drawn from over 30 prisons. RESULTS: The results indicated that individuals who entered and completed in-prison residential treatment were less likely to experience the critical postrelease outcomes of new arrests and substance use during the first 6 months following release. CONCLUSIONS: Without controlling for selection bias, the effects of treatment would most likely have been attenuated. The results have greater generalizability than other studies of prison-based treatment. This study occurred within a multisite context of 20 programs serving both male and female inmates and operating within different security levels and different geographic regions.

Adult↗

PubMed2006

Recent trends in adolescent substance use, primary care screening, and updates in treatment options.

PURPOSE OF REVIEW: To provide a brief overview on trends in common substances of abuse in adolescents, a summary of tools to evaluate adolescent substance abuse in an outpatient setting, and an update of outpatient and inpatient treatment options. RECENT FINDINGS: Recent national data suggest an overall slight decline in the use of tobacco, crystal methamphetamine, heroin, and club drugs. No significant change was noted in the use of alcohol, marijuana, and cocaine. Yearly screening of all adolescents for substance use is recommended. This can be accomplished in an office setting using mnemonics, structured interview techniques, and brief screens for substance abuse. If a problem is identified, various outpatient and inpatient treatments are available. Individual, family, and group therapy methods are available. Other options include acute detoxification programs, partial hospitalization, acute residential treatment, residential treatment centers and wilderness programs. Pharmacological treatments are available for nicotine, alcohol, and opioid addiction. SUMMARY: Tobacco, alcohol, marijuana, and other drugs remain a significant problem among adolescents in the United States. Pediatricians should screen and assess all adolescents on a yearly basis. If a problem is identified, there are many options for treatment, including pharmacologic treatment as well as individual, family, or group therapy in an inpatient or outpatient setting.

Adolescent↗

PubMed2004

Outcomes of supported housing for homeless veterans with psychiatric and substance abuse problems.

This study examines the effect of previous participation in time limited residential treatment and other factors on treatment outcomes among homeless veterans with serious mental illness placed into permanent supported housing. The sample consisted of 655 veterans placed into supported housing at 18 sites through the VA's Healthcare for Homeless Veterans (HCHV) Supported Housing Program during the period 1993-2000. Data on client and program characteristics, and treatment outcomes, were documented by HCHV case managers staffing these programs. Data on use of VA services, including time limited residential treatment received 6 months prior to entry into supported housing, were extracted from VA administrative files. The relationship of prior residential treatment, as well as other measures of client characteristics, service use, and program characteristics, to outcomes were assessed using both bivariate and multivariate Cox proportional hazards regression and logistic regression. After adjusting for client characteristics, service use, and program characteristics, no differences in outcomes were found between clients who had received prior residential treatment and those placed directly into permanent supported housing. Prior residential treatment appears to have little effect on treatment outcomes among formerly homeless veterans placed into permanent supported housing programs providing indirect support for the direct placement supported housing model.

Adult↗

PubMed1975

Minor physical anomalies in normal, neurotic, learning disabled, and severely disturbed children.

A high incidence of minor physical anomalies in a childhood schizophrenic population has been previously reported by Goldfarb. In the present study, 108 boys from four different clinical populations were examined, utilizing a standardized anomaly scoring system for which a high interrater reliability was obtained. The patient populations were: general pediatric ward patients (n = 31), psychoneurotic outpatients at a university child guidance clinic (n = 26), learning diabled children (n = 23), and autistic, borderline, and atypical children (n = 28) from two residential treatment centers. Both the learning disabled and residential treatment populations had higher mean anomaly scores than did the first two groups, but did not differ significantly from each other. There was a trend for patients with multiple anomalies to have had more frequent history of prenatal insults or paternal psychopathology. These results indicate that the development of these minor anatomical anomalies which are formed in the first three months of fetal development may parallel early developmental deviation of the central nervous system. The finding of high anomalies in the residential treatment groups supports the idea that some of these patients share a common etiology with the other early developmental deviations, such as speech delay or mental retardation, for which high anomaly scores have also been reported.

Abnormalities, Multiple↗

PubMed2001

Alternative solutions to the problem of selection bias in an analysis of federal residential drug treatment programs.

In an evaluation of prison-based residential drug treatment programs, the authors use three different regression-based approaches to estimating treatment effects. Two of the approaches, the instrumental variable and the Heckman approach, attempt to minimize selection bias as an explanation for treatment outcomes. Estimates from these approaches are compared with estimates from a regression in which treatment is represented by a dummy variable. The article discusses the advantage of using more than one method to increase confidence in findings when possible selection bias is a concern. Three-year outcome data for 2,315 federal inmates are used in analyses where the authors separately examine criminal recidivism and relapse to drug use for men and women. Statistical tests lead the authors to conclude that treatment reduces criminal recidivism and relapse to drug use. The treatment effect was largest when the inference was based on the Heckman approach, somewhat smaller when based on the instrumental variable approach, and smallest when based on the traditional dummy variable approach. Treatment effects for females were not statistically significant.

Crime↗

PubMedDate not supplied

Afrocentric treatment in residential substance abuse care. The Iwo San.

Alcohol and other drug treatment programs continue to report relatively low success rates among African-American participants. We propose that there is a need to consider treatment approaches that are more culturally competent. An Afrocentric paradigm is suggested and instituted as the central theme of a residential drug treatment program. Elements of an Afrocentric orientation and how these principles are used to guide the development of a treatment philosophy are discussed.

Black or African American↗

PubMedDate not supplied

Family-based, in-home services for the severely emotionally disturbed child.

FBS was not conceived as a substitute for a residential treatment program. It was instead established to provide a greater array of services in the center's continuum of care and another treatment alternative. Although children were accepted into the FBS program when residential treatment was indicated, it was not because the program was considered an equal to residential treatment. Rather, we felt the child and family could receive greater benefits from an in-home approach [Willner et al. 1972]. The results of intensive family-based services speak for themselves in terms of cost-effectiveness, placement prevention, and family reunification [Bryce and Lloyd 1980a]. It has been the center's experience that the most vulnerable children are those who have been removed for extended periods of time to an institutional setting. Results of table 1 indicate that 68% of the children receiving FBS aftercare remained in their homes, while children who were served before any placement remained in their homes 97% of the time. In spite of major behavioral changes experienced by the child and family during the residential course of treatment, the staff reports the following obstacles to successful reunification: Child "identified" as the problem is often expected to return home as a different human being without needs or problems. Temporary expulsion of the identified child often immediately relieves family stress, yet begins a process of homeostatic adjustment whereby the system closes, excluding the child.(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Symptoms↗

PubMed2003

Gaining insight: who benefits from residential, integrated treatment for people with dual diagnoses?

This retrospective study examines 18-month outcomes for 38 participants in an urban, residential integrated treatment (IT) program, and whether residents experienced different treatment benefits. Informed by an ACT team approach, the program emphasized harm reduction and motivational interventions. The design is naturalistic, and outcomes are self-comparisons over time reported in the aggregate. Repeated measurements with three standardized scales tracked stage of treatment and extent of alcohol and drug use. Outcomes analyses reveal advancements in stage of treatment and significant reductions in use of alcohol and drugs. Participants also worked more and were hospitalized less.

Adult↗

PubMed1999

Women in residential drug treatment: differences by program type and pregnancy.

This study compared the characteristics of 4,117 women treated in publicly funded residential drug treatment programs in Los Angeles County between 1987 and 1994 by pregnancy status and program gender composition, that is, women-only and mixed-gender programs. A logistic regression analysis determined the predictors of program completion. Women in women-only programs were more likely than women in mixed-gender programs to be pregnant, homeless, or on probation; to use methamphetamines; to use alcohol; and have prior drug treatment. Pregnant women were younger, more likely to be homeless, had fewer years of drug use, were more often referred by other service providers, and were less likely to have injected drugs or have prior drug treatment than non-pregnant women. Although women in women-only programs had more problems, they spent more time in treatment and were more than twice as likely to complete treatment as compared with women in mixed-gender programs.

Adult↗