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Results for “RESIDENTIAL TREATMENT”

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PubMed2005

Psychological distress tolerance and duration of most recent abstinence attempt among residential treatment-seeking substance abusers.

This study investigated the relationship between duration of most recent drug and alcohol abstinence attempt and psychological distress tolerance, as indexed by persistence on a mental arithmetic task (the Paced Auditory Serial Addition Task; D. M. A. Gronwall, 1977), in 89 individuals in an inner-city residential substance abuse treatment facility. Results indicated that most recent abstinence duration was related to persistence on the psychological stressor, beyond the influence of demographics, substance use level, and negative affect. These findings extend previous work (T. H. Brandon et al., 2003; R. A. Brown, C. W. Lejuez, C. W. Kahler, & D. Strong, 2002) reporting significant relationships between persistence on laboratory challenge procedures and duration of abstinence following a quit attempt in smokers, suggesting that common processes account for relapse across addictions. Systematic replications including a prospective design are recommended.

Adult↗

PubMed1996

Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988-92: II. Alcohol problems.

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with alcohol problems over the years 1988-92. There were no changes in the mean age and sex ratio of admissions, with the treatment population in all years predominantly males in their mid-thirties. There was a decrease in the proportion of clients who were employed full-time (25.1-16.4%), and an increase in admissions with criminal histories (45.7-59.3%). More than half of admissions in all years had alcohol problems of greater then 10 years' standing. The percentage of people who had never been in treatment before decreased from 44.4% in 1988 to 18.7% in 1992.

Journal Article↗

PubMed2001

Racial and ethnic differences in drug treatment entry of injection drug users in Massachusetts.

This article examines patterns of drug treatment entry among 28,000 adult injection drug users (IDUs), with special attention to racial and ethnic differences. The data analyzed originates from a statewide drug-treatment database covering four years. Through the use of logistic regression analysis, the study identified significant population differences between those who used detoxification only, those who used residential treatment and those who used methadone maintenance. Latino IDUs were approximately a third less likely than Caucasian IDUs to enter residential treatment and African American IDUs were half as likely as Caucasian IDUs to enter methadone maintenance treatment. This article discusses specific programmatic and research implications including the need to determine whether differential entry rates are due to access, client awareness, cultural, referral or other factors.

Adult↗

PubMed2006

Unlicensed residential programs: the next challenge in protecting youth.

Over the past decade in the United States, the number of private residential facilities for youth has grown exponentially, and many are neither licensed as mental health programs by states, nor accredited by respected national accrediting organizations. The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) is a multi-disciplinary group of mental health professionals and advocates that formed in response to rising concerns about reports from youth, families and journalists describing mistreatment in a number of the unregulated programs. This article summarizes the information gathered by A START regarding unregulated facilities. It provides an overview of common program features, marketing strategies and transportation options. It describes the range of mistreatment and abuse experienced by youth and families, including harsh discipline, inappropriate seclusion and restraint, substandard psychotherapeutic interventions, medical and nutritional neglect, rights violations and death. It reviews the licensing, regulatory and accrediting mechanisms associated with the protection of youth in residential programs, or the lack thereof. Finally, it outlines policy implications and provides recommendations for the protection of youth and families who pursue residential treatment.

Accreditation↗

PubMed1998

Overt categorical aggression in referred children and adolescents.

OBJECTIVE: To investigate descriptive and predictive correlates of aggression in children and adolescents who exhibit a high frequency of daily physical assault after admission to a structured residential treatment program and to examine correlations between subcategories of overt categorical aggression (OCA) in the same population. METHOD: Fifty-one admissions to a residential treatment program were assessed for frequency of physical assault after admission; analyses were corrected for length of stay. Patients with a high frequency of daily assault were compared with patients with a low frequency of daily assault on variables assessing demographics, history, family, concurrent behavior, treatment, and outcome. RESULTS: A high prevalence of OCA was found in this sample. Variables assessing history and concurrent behavior were significantly associated and predictive of subjects exhibiting a high frequency of daily physical assault after admission. Physical assault was significantly correlated with verbal aggression, property destruction, and self-injurious behavior. CONCLUSIONS: These findings support the distinctiveness of OCA as a separate subtype of aggression encompassing four subcategories. Further research on treatment, outcome, and associated comorbidity of OCA is warranted.

Adolescent↗

PubMed2003

Analysis model for planning chemical dependence treatment systems.

Statewide needs assessments commonly generate a single estimate of the number of persons needing chemical dependence treatment. The present analysis utilizes help-seeking behavior models and patient placement concepts to break a single statewide need estimate into operational units of services and costs that can be used for planning and resource allocation. The analyses are presented as allocation models for placements, service populations, service capacities, and costs. The guide was tested using state data for a target year and the results were compared to actual treatment admissions, which revealed a lack of convergence. Only 9% of persons were estimated to need intensive residential treatment whereas actual admissions to intensive residential treatment accounted for 29% of all admissions. The disparities may be accounted for by sampling bias of the needs estimate and by the likelihood that persons with more severe problems may be overrepresented when only a small proportion of treatment need is being met. These findings suggest that if resources become available to narrow the treatment gap, a larger proportion of outpatient services and less intensive services may be appropriate for the expanded clientele.

Health Planning↗

PubMed1999

Modified therapeutic community for homeless mentally ill chemical abusers: emerging subtypes.

This paper is one of a series reporting on a clinical field trial evaluating the efficacy of the modified therapeutic community (TC) approach for the treatment of homeless mentally ill chemical abusers (MICAs). The social and psychological characteristics of the treatment sample were described in an earlier paper; the purpose of the present report was to categorize subtypes of homeless MICA clients to predict with greater accuracy their treatability in modified TCs. An index that consistently correlated with treatment-relevant variables was identified for each of three dimensions; Homelessness (residential instability), Mental Illness (current severity), and Substance Abuse (current substance abuse/dependence diagnosis). These indices yielded distributions that captured the variability in the sample with respect to a number of variables, including drug use, criminality, human immunodeficiency virus (HIV) risk (sexual behavior), psychological status, and motivation. Bivariate and multivariate analyses showed that the indices were not strongly related to demographic variables such as race/ethnicity, age, or gender, but were significantly associated with baseline drug use, criminal activity, HIV risk (sexual behavior), psychological symptoms, and motivation and readiness. These findings indicate that, even among those admitted to residential treatment for substance abuse, homeless MICA clients are not homogeneous; rather, subgroup differences emerge among the indices of homelessness, mental illness, and substance abuse. The efficacy of treatment in modified TCs for these subgroups will be assessed in subsequent papers examining the relationships among the three indices, client retention, and outcomes during and subsequent to residential treatment.

Diagnosis, Dual (Psychiatry)↗

PubMed1990

A bridge to the community for extended-care state hospital patients.

In early 1988 a discharge assessment team surveyed the records of 421 extended-care patients at Washington's Western State Hospital to facilitate planning for patients who were able to move out of the hospital. The group as a whole manifested serious problem behaviors, both current and past. Less than 40 percent of the patients needed continued state hospital care, but most who could be discharged to the community would require intensive residential supervision and support. The authors review linkages between two kinds of residential treatment programming that exists for this population, a network of community residential treatment facilities operated by private providers and community mental health centers and a hospital-based transitional program called the Program for Adaptive Living Skills. Linkages between these programs have proved useful in the residential placement of extended-care patients.

Adult↗

PubMed2004

Patterns and correlates of treatment: findings of the 2000-2001 NSW minimum dataset of clients of alcohol and other drug treatment services.

The aim of this study was to provide an overview of the first year of the NSW Minimum Dataset for Alcohol and Other Drug Treatment Services data collection, including describing the patterns and correlates of people having received treatment in New South Wales. All closed treatment episodes for the 2000-2001 financial year were included for descriptive, univariate and multivariate analyses. There were 33,459 closed episodes of care in New South Wales in the 2000/2001 financial year. The majority of clients (69%) were male and the mean age was almost 34 years. The majority of treatment is sought for problems related to alcohol (37%) and heroin (33%) use. More than a third (40%) of clients were new to drug and alcohol treatment. Half the clients had a history of injecting drug use with 6.3% of those with heroin as their principal drug of concern, never having injected. The most common main service provided was in-patient withdrawal (26%). Multivariate logistic regression revealed that being older, not homeless, non-indigenous and having heroin as the principal drug of concern predicted receiving out-patient withdrawal management. Analyses of length of stay in residential treatments and number of service contacts in non-residential treatments are reported. The NSW MDS AODTS is a critical information source for policy development, service planning and surveillance. The results of this paper illustrate the utility of the data collection for identifying emerging issues in the patterns of drug use and service delivery for clients with alcohol and other drug problems.

Adolescent↗

PubMed1996

Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988-92: I. Illicit drug problems.

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with illicit drug problems over the years 1988-92. The mean age of admissions rose from 26.8 years to 27.9 years over the study period. There was a small increase in the proportion of male admissions to agencies (66.5% in 1988 to 69.9% in 1992). The proportion of admissions reporting opiates as their primary drug problem declined from 81% to 65%, while the proportion of admissions for stimulant problems doubled in that period (8% to 16%), as did those for cannabis (3.6% to 8.7%). There was a significant increase in the proportions of admissions who had drug problems of 10 or more years' standing (34.9-41.3%). The proportion of admissions that had never been in treatment decreased from 51% to 15% over the study period. Admissions with prior methadone experience rose from 37% to 69% between 1988 and 1992.

Journal Article↗

PubMed1976

A model for interagency cooperation in the provision of mental health services to youths.

In 1971 the Chedoke-McMaster center initiated an assessment and placement program for emotionally disturbed preadolescents in the Hamilton, Ontario, area. That project was used as the springboard for a cooperative venture with other health and social service agencies dealing with children. At the heart of the collaborative project is a multidisciplinary team, composed of representatives from the various participating agencies, that is responsible for all clinical decision-making regarding the need for impatient assessment and placement in residential treatment programs. The team also participates in the planning for discharge and aftercare. The other two components of the project are a short-term inpatient cottage assessment unit and several long-term residential treatment programs.

Child↗

PubMed2006

An interactive voice response program to reduce drinking relapse: a feasibility study.

Substance-abusing patients often relapse soon after undergoing treatment, thus requiring intensive aftercare or re-treatment. More efficient monitoring and follow-up of patients could contribute to better treatment outcomes. This study evaluated the feasibility of a computer-automated interactive voice response (IVR) system to reduce relapse following discharge from residential treatment. Sixty participants completing a residential treatment program and meeting DSM-IV criteria for alcohol dependence were randomized to three groups: (1) daily IVR reporting with personal follow-up on noncompliant callers; (2) daily IVR reporting without follow-up; or (3) no IVR reporting (control group). At 30, 90, and 180 days after discharge, participants were interviewed to obtain timeline follow-back drinking data and completed the Work and Social Adjustment Scale, Obsessive-Compulsive Drinking Scale, SF-36, and Drinker Inventory of Consequences. This pilot study suggests that using automated IVR technology to monitor clients after discharge is feasible and warrants further research and development. IVR systems also provide the potential for delivering individualized feedback.

Adult↗

PubMed1993

A preliminary trial of ascorbic acid as supplemental therapy for autism.

1. This study presents the results of a 30-week double-blind, placebo-controlled trial exploring the effectiveness of ascorbic acid (8g/70kg/day) as a supplemental pharmacological treatment for autistic children in residential treatment. 2. Residential school children (N = 18) were randomly assigned to either ascorbate-ascorbate-placebo treatment order group or ascorbate-placebo-ascorbate treatment order group. Each treatment phase lasted 10 weeks and behaviors were rated weekly using the Ritvo-Freeman scale. 3. Significant group by phase interactions were found for total scores and also sensory motor scores indicating a reduction in symptom severity associated with the ascorbic acid treatment. 4. These results were consistent with a hypothesized dopaminergic mechanism of action of ascorbic acid.

Adolescent↗

PubMed1981

Children who set fires: some background and behavioral characteristics.

Background and behavior of 90 children identified as fire-setters in a population of 544 referred for residential treatment is presented. None exhibited fire-setting behavior while in residential treatment, but questions are raised about alternative treatments achieving the same result. A current bibliography is provided.

Adolescent↗

PubMed2005

Evolving a model for integrated treatment in a residential setting for people with psychiatric and substance use disorders.

This paper discusses the implementation of a residential, integrated treatment program serving dually diagnosed people with histories of homelessness. Attention is focused on the program structure and how the program developed over time. Program modifications tended to relax program rules and embrace a motivational, stage-wise model using harm-reduction principles. Despite initial skepticism regarding these modifications, outcomes such as program retention, abstinence from substances, employment, and hospitalization improved.

Adolescent↗

PubMed1994

An examination of the internal consistency and factor structure of the eating disorder inventory-2 in a clinical sample.

We examined the internal consistency and factor structure of the newly revised version of the Eating Disorder Inventory (EDI), with particular emphasis on the examination of the three new provisional scales: Asceticism, Impulse Regulation, and Social Insecurity. Subjects were 300 women who were seeking treatment at a residential treatment facility for women with eating disorders. Chronbach's alphas ranged from .80 to .91 for the eight original scales whereas coefficients for the three new scales were all less than .80, the criterion stated as being necessary for inclusion in the test. Item-total correlations were also substantially lower for the three new scales. The results of principal components analyses with orthogonal rotation supported the factor structure of the original 64-item EDI, but not the three additional scales. These data generally supported the reliability and factor structure of the original eight scales but did not support the reliability or validity of the three provisional scales.

Adolescent↗

PubMed2002

Preventing lung cancer by stopping smoking.

Much progress has been made in recent years in treating tobacco dependence. The 2000 USPHS Guideline extends the understanding of effective treatments and encourages clinicians to be more diligent in recognizing tobacco users in the practice and more aggressive in treating every tobacco user. The guideline outlines the potential use of the five first-line medications (bupropion, nicotine patches, gum, nasal spray, and inhaler) and the two second-line medications (nortriptyline and clonidine). The use of these medications can be tailored to meet the patients needs and combinations of these medications can be used when appropriate. More intensive treatment, such as residential treatment, may be needed for more addicted smokers.

Female↗

PubMed1999

A review of recent findings on substance abuse treatment for pregnant women.

Recent years have brought an increased interest in the treatment needs of pregnant substance abusers. This article reviews the literature on this subject, providing an overview of what is known about the prevalence of substance abuse during pregnancy; the factors in women's lives, especially pregnant women, that lead to substance abuse and that facilitate and impede treatment success; and the components of successful treatment programs. The prevalence of prenatal illicit drug use is known to be about 5% of all pregnant women nationwide, with higher rates for selected subgroups. Local studies have shown much higher rates. Substance abuse is associated with poverty, with the substance abuse of significant others, and with family violence. Perinatal substance abusers experience poorer birth outcomes. The negative consequences for babies do not stop at birth; home environments may be chaotic and often children are removed from their mother's care if substance abuse continues after birth. While the literature on prevalence, correlates, and outcomes of perinatal substance abuse is plentiful, there continues to be sparse information on successful treatment approaches. Sample sizes are small and there are few studies with adequate comparison groups. The small number of outcome studies we review suggest that, as with the broader treatment literature for other populations, success (as measured by abstinence) is associated with retention. Retention is facilitated by the provision of support services, such as child care, parenting classes, and vocational training. There is no clear empirical basis for concluding that one type of treatment (for example, residential treatment) is more effective than another.

Adolescent↗