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PubMedDate not supplied

Guilt, shame, and depression in clients in recovery from addiction.

Men and women in recovery from addiction were compared on levels of depression, guilt, and shame. The measurement of guilt included subscales of Survivor Guilt, Separation Guilt, Omnipotent Responsibility Guilt, Trait Guilt, State Guilt, and Adaptive Guilt. The sample included 75 men and 33 women in treatment in a residential treatment community. It was found that women were significantly higher than men in depression. The recovering subjects were compared to nonaddicted subjects and established norms, and it was found that the recovering people were higher on depression, shame, and the subscales of maladaptive guilt. Both men and women in recovery were significantly lower than norms in adaptive guilt.

Adult↗
PubMed1979

Depression in childhood. 1: Clinical correlates of depressed children admitted for treatment to a residential program.

Ninety-three children with a diagnosis of depression were admitted to a residential children's unit over a six-year period. Background and clinical data were analysed in order to identify correlates associated with the disorder and to examine the concept of 'depressive equivalents'. The results indicated that parental loss, particularly loss of father, through death or desertion, psychiatric illness in the parents and stressful events in early childhood were important concomitants of the disorder. The study also supported the current literature on 'depressive equivalents' and their expression in childhood.

Adjustment Disorders↗
PubMed1988

Attitudes toward death in adolescent offspring of Holocaust survivors: a comparison of Israeli and American adolescents.

This paper is a continuation of a study begun in 1978 on attitudes toward death. A comparison study of Israeli and American adolescent offspring of Holocaust survivors who are in treatment in a residential treatment program in Jerusalem, Israel, is detailed. Biographical data, diagnostic classifications, a review of Thematic Apperception Test (TAT) responses and some dreams are presented. Israel is shown to be a therapeutic venue that allows the adolescent to redevelope a damaged identity.

Adolescent↗
PubMed1978

The parent-therapist program: alternate care for emotionally disturbed children.

The development of an alternative to residential treatment centers is described. Healthy nuclear families are recruited and, in groups of five couples each, encouraged to function as extended families. Training in appropriate therapeutic techniques enables them to treat several disturbed children in their own homes. Evaluation of the program indicates that outcome does not differ significantly from that of residential treatment, but that costs are markedly lower.

Affective Symptoms↗
PubMed1996

Adolescents in therapeutic communities.

This study was designed to compare the course of change of two groups of conduct-disordered adolescents in two theoretically distinct residential treatment programs: a Therapeutic Community and a modified Token Economy. In all, 28 clients were assessed on multiple measures at three points in the treatment process in a repeated measures design. Results of the study indicated that, despite an overall trend toward improvement in both groups, there was little significant difference between the rates of progress over time. Dropouts and nondropouts could be differentiated only by a small number of baseline scores and the amount of family contact during placement. While comparative studies in residential treatment have been lacking, it appears that a more promising approach would be to examine common features of different models. The results of this study support the need for qualitative research focusing on the interaction of client attributes and underlying components of treatment modalities.

Adolescent↗
PubMed2005

Gender differences in the progression of co-morbid psychopathology symptoms of eating disordered patients.

This study examined the utility of the Personality Assessment Inventory (PAI) in screening for comorbid psychopathology in eating disordered males and females undergoing residential treatment. The PAI, a self-administered screening tool containing 344 items to provide information on 11 clinical constructs, was administered at admission and discharge to 181 patients, 154 females and 27 males. Average age was 26.88 years (SD=9.35) and average length of stay was 58.31 days (SD=39.94). The results showed that both male and female patients exhibit several comorbid disorders at admission to residential treatment and the severity of these symptoms was statistically significantly reduced over the course of treatment. When comparing differences among genders, the results show that females present with more psychopathology symptoms at the start of treatment but make better progress than males in reducing these symptoms over time. When comparing patients across eating disorder diagnoses, subjects with bulimia displayed more severe comorbid symptomatology as compared to those with anorexia or other eating disorders. A thorough clinical assessment of eating disordered patients including comorbid psychopathology disorders is relevant for clinical diagnosis, treatment planning, and perhaps ultimately the outcome of treatment.

Adolescent↗
PubMed1961

Emotionally disturbed children and adolescents. California State Department of Mental Hygiene programs.

Through programs that are directly operated by the state and through subsidy programs using state funds and federal funds, the Department of Mental Hygiene in California provides services for children and adolescents who are emotionally disturbed. Private institutions for these purposes, in the form of residential centers and day care centers, are licensed by the Department of Mental Hygiene. Direct services provided by the Department of Mental Hygiene include residential treatment programs and outpatient clinic services. There have been increased demands for more residential treatment programs and for services for rural areas. Indications have been noted of increased need for research on questions dealing with services of this kind and increased training programs to provide adequate numbers of trained personnel.

Adolescent↗
PubMed1990

Change in adolescent boys at teen ranch: a five-year study.

A five-year study was undertaken to assess the effectiveness of the Teen Ranch 70-bed residential treatment program for adolescent boys. To date, no long-term study of treatment effectiveness has been conducted; research has concentrated on recidivism, and while this provides some meaningful information, it provides little or no data to treatment directors, therapists, and administrators concerning in-process therapy or client change issues. The present study compared 120 full psychological test and retest batteries of boys who were in the program for at least one year. Through test-retest analysis, 27 intellectual and personality variables were compared to describe changes that took place. Nine intellectual and academic change variables and nine personality change variables were found to be significant. These changes were utilized to examine the overall effectiveness of the Teen Ranch residential treatment program and the possibility of integrating evaluation and treatment processes.

Achievement↗
PubMed2001

Treatment compliance in the trajectory of treatment progress among offenders.

Research on drug treatment process has been limited, with most studies centering on individual and program factors associated with successful treatment completion. Recent literature has begun highlighting the salience of treatment engagement in reducing drug dependence among criminal offenders. This study descriptively analyzes incidents of treatment noncompliance identified in monthly progress reports for 150 criminal justice-mandated clients in residential treatment. We identify seven problem types and seven dimensions of noncompliance in the trajectory of treatment engagement. The latter are prevalence, frequency, types, specialization, temporal distribution, paths, and correlates. It is found that incidents of rule violations are common among criminal justice participants of residential treatment. Although for most clients these troubles do not appear to evolve into serious obstacles to recovery, a few clients with a high frequency of noncompliant behavior never engage in treatment. Clinical implications for improving treatment engagement and retention are discussed.

Adult↗
PubMed1997

Influence of retroactive disability payments on recipients' compliance with substance abuse treatment.

OBJECTIVE: This study examined whether substance abusers who received large retroactive payments from Social Security disability programs were more likely to terminate residential treatment precipitously than those who did not receive payments. METHODS: The records of 43 patients of a long-term residential treatment facility who received disability payments at some point during their treatment stay were blindly examined. Twenty-six of these patients received a large one-time retroactive payment representing money that accumulated during processing of the claims. To test the hypothesis that receipt of such a payment would lead to precipitous discharge, a survival regression model was used. A control group of nonrecipient patients was sampled at a comparable point in treatment. RESULTS: Subjects in the recipient group were significantly more likely to have unplanned discharges than those in the comparison group. CONCLUSIONS: These preliminary data suggest that large cash infusions can be disruptive to the course of treatment for substance abusers.

Adult↗
PubMed1993

Trends in the development of alcohol and drug treatment services in Ontario: a replication and extension of a previous study.

This paper summarizes the major trends in the development of alcohol and drug treatment services in Ontario from 1979 to 1989. Data were obtained from all treatment services in the province by surveys undertaken in 1980, 1983, 1986 and 1989. Supplementary archival data are included on the use of American treatment programs by Ontario residents over a similar time period. Across the period of analysis, there has been a rapid increase in the number of alcohol and drug programs (130 to 217), their total cost ($44.4 million to $77.1 million) and the total treatment caseload (30,356 to 61,622). With respect to different types of services, the largest growth in capacity has occurred for specialized assessment/referral centres. Use of short-term residential resources within the province has risen slightly but this has been augmented by a rapid increase in the use of similar programs in the United States. Contrary to expectations from research evidence and provincial policy initiatives, only modest gains have been experienced with non-residential treatment alternatives compared to the increases in availability and utilization of residential treatment programs.

Alcoholism↗
PubMed1992

The Devereux Adolescent Behavior Rating Scale: a tentative model of second-order factor structure across independent clinical samples.

The second-order factor structure of the Devereux Adolescent Behavior Rating Scale was examined in (a) a sample of 254 adolescents who were receiving residential treatment for severe emotional/behavior disorders and (b) an independent sample of 404 adolescents hospitalized for substance abuse. A plausible range of factors was estimated for each group through parallel and average partial analyses and suggested wither a two- or three-factor solution. Subsequent congruence analyses provided tentative support for a three-factor model: (a) undercontrolled/disruptive behaviors; (b) withdrawn/psychotic behaviors; and (c) needs approval/dependent behaviors. The third factor was poorly defined in the residential treatment sample, but extraction of the third factor increased the across-group replicability of the first two factors.

Adolescent↗
PubMed1988

Housing the homeless mentally ill: a longitudinal study of a treatment approach.

In a one-year study of 49 homeless chronic mentally ill patients, the subjects, selected at admission for inpatient treatment, were randomly assigned to one of two groups. One group was placed in an experimental residential treatment program following discharge, and the other group received standard postdischarge care. Subjects were interviewed every four months during the year as well as at index hospitalization and discharge. Although the study remains exploratory due to the small sample size and case attrition, the authors found that compared with the control group, the subjects in the residential treatment program spent significantly more nights in adequate shelter, spent fewer nights in hospitals or undomiciled, and were more satisfied with and committed to their living arrangements.

Chronic Disease↗
PubMedDate not supplied

Parenting training for women in residential substance abuse treatment. Results of a demonstration project.

This paper presents findings on the impact of implementing a parenting component in two urban residential treatment programs in Massachusetts for pregnant and parenting chemically-dependent women. The parenting component consisted of multiple services for both women and their infants while they were in residential treatment as well as aftercare services after discharge from treatment. Findings presented focus on: (a) the characteristics of the 170 pregnant and parenting women who participated in the parenting component during its 48 months of implementation; (b) changes in the parenting skills and self-esteem of women who completed parenting training; (c) the quality of mother-child interaction; and (d) the participants' perceptions about the impact of the parenting training. Women in both programs made dramatic improvements in self-esteem and experienced significant gains in parenting knowledge and attitudes. The participants were also overwhelmingly positive about the impact of the parenting training on their lives. Study findings underline the importance of parenting services for pregnant and parenting women in residential substance abuse treatment.

Adult↗
PubMed1986

Factors related to the treatment success of drug addicts enrolled in a residential rehabilitation facility.

Twenty-one young adult drug addicts stipulated to a residential treatment center and judged to have successfully completed the center's therapeutic program were compared with another group from the same center who had failed to successfully complete the program. The two groups were matched as closely as possible on sex, race, age at admission, and marital status, and they were compared, using a multivariate analysis of variance (MANOVA), on the dimensions of family instability, criminal record, severity of drug use, prior treatment, educational level, self concept, and family self concept. Analysis revealed that two groups significantly differed as a function of the dependent measures, with educational level and prior treatment accounting for most of the difference.

Adolescent↗
PubMed2001

Involuntary treatment of alcohol-dependent patients: a study of 17 consecutive cases of civil commitment.

AIM: To investigate the baseline and follow-up characteristics of a group of alcohol-dependent patients being treated under civil commitment. METHODS: This study involved a cross-sectional comparative analysis of baseline characteristics and a follow-up survey of a group of committed alcoholic patients. The study was undertaken in the Alcohol Unit of a 1,000-bed general and university hospital. The study included 17 consecutive cases of civil commitment (representing 15 patients, of whom 2 were committed twice) and a comparative group of 34 randomly selected age- and sex-matched patients. Baseline characteristics of the cases (at the time of commitment) and of patients from the comparative group were collected from medical records, including sociodemographic data, medical condition, patterns of drinking and number and dates of previous treatments for alcohol-related problems. A structured follow-up interview of the cases provided information on their medical condition, social status, patterns of alcohol use, type and duration of residential treatment as well as their perceptions of commitment. RESULTS: During a 4-year period, our Unit referred 23 cases of alcohol-dependent patients (out of 367) to the Guardianship Authority, requesting civil commitment. On 17 occasions, patients were committed to residential treatment, including 2 patients who underwent commitment on two separate occasions, thus representing a total of 15 different patients. In comparison with age- and sex-matched patients seen at the Unit, the cases were characterized by multiple medical, social and psychological alcohol-related impairments. At the time of follow-up, 14 out of 15 patients were alive, among whom 10 agreed to be interviewed. Eight of these reported complete abstinence, whereas 9 considered their alcohol problem as less severe than before. The average duration of commitment was 29 weeks. The majority of patients retrospectively considered the measure as having been justified and useful. The patients' satisfaction with the decision to commit was higher among women than among men. Health-related quality of life at the time of follow-up, as assessed by the MOS 36-Item Short Form Health Survey questionnaire, was good on average and better than that usually reported by other cohorts of alcoholics undergoing treatment. CONCLUSIONS: The usefulness of residential civil commitment of certain severely impaired alcohol-dependent patients is underscored. This study suggests that civil commitment not only may save the lives of endangered patients but could also be a health-promoting measure that may sometimes allow for recovery from dependence. Unexpectedly, this measure was retrospectively well accepted by many patients, who considered the commitment decision as having been justified and useful.

Alcoholism↗