PubMed Health⌕ Search

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 541 records · Page 30Linked to original sources
PubMed2006

The Network for the Improvement of Addiction Treatment (NIATx): enhancing access and retention.

The Network for the Improvement of Addiction Treatment (NIATx) teaches participating treatment centers to use process improvement strategies. A cross-site evaluation monitored impacts on days between first contact and first treatment and percent of patients who started treatment and completed two, three and four units of care (i.e., one outpatient session, 1 day of intensive outpatient care, and 1 week of residential treatment). The analysis included 13 agencies that began participation in August 2003, submitted 10-15 months of data, and attempted improvements in outpatient (n=7), intensive outpatient (n=4) or residential treatment services (n=4) (two agencies provided data for two levels of care). Days to treatment declined 37% (from 19.6 to 12.4 days) across levels of care; the change was significant overall and for outpatient and intensive outpatient services. Significant overall improvement in retention in care was observed for the second unit of care (72-85%; 18% increase) and the third unit of care (62-73%; 17% increase); when level of care was assessed, a significant gain was found only for intensive outpatient services. Small incremental changes in treatment processes can lead to significant reductions in days to treatment and consistent gains in retention.

Humans↗
PubMed2002

Child sexual abuse treatment: misinterpretation and mismanagement of child sexual behavior.

OBJECTIVE: The purpose of the study was to examine caregiver understanding of the impact of child sexual abuse and the management of abused children in residential treatment. METHODS: A purposive sample of 20 registered nurses and child care workers were interviewed about their experiences working in residential treatment and their knowledge about child development and child sexual abuse and its application to practice. Data from interviews and field notes were analysed using dimensional analysis. FINDINGS: Caregivers had limited knowledge of the sequelae of child sexual abuse. Developmentally appropriate behaviour of sexually abused children, as well as behavioural manifestations of child sexual abuse, were often misinterpreted and mismanaged. CONCLUSION: Residential care of sexually abused children should be based on sound developmental principles and caregiver sensitivity.

Adolescent↗
PubMed2004

The practice and process of healthy exercise: an investigation of the treatment of exercise abuse in women with eating disorders.

This study investigates the effectiveness of an exercise program designed to reduce exercise abuse in women who are in residential treatment for eating disorders. One hundred and twenty-seven women who participated in the exercise program were compared to 127 non-participants on weight gain and self-reported obligatory attitudes and beliefs about exercise. The exercise participants were women who were medically cleared and attended at least two exercise groups during treatment. The control group were women who were medically cleared, but did not attend any exercise groups during treatment. Significant group x diagnosis interactions revealed that women in the exercise group who were diagnosed with anorexia nervosa gained more than one-third as much weight as those in the control group. Also, women in the exercise group demonstrated significantly reduced obligatory attitudes toward exercise compared to the control group. These findings suggest that the use of an exercise program that targets exercise abuse in women with eating disorders is feasible during residential treatment and results in positive change without interfering with weight gain. Limitations that result from the lack of random assignment to the exercise and control group are discussed.

Journal Article↗
PubMedDate not supplied

Substance abuse treatment options: a federal initiative.

Pervasive drug enforcement efforts and new federal sentencing guidelines have led to an increase in substance abusers entering the federal prisons. Although the Federal Bureau of Prisons (BOP) has been committed to providing substance abuse treatment since the 1960s, a comprehensive expansion of its programs was necessary so that quality services could be provided for the growing drug-offender population. This article describes the BOP's six-part drug treatment strategy, which includes screening, education, residential treatment, nonresidential treatment, transitional treatment, and evaluation. The programs entail a biopsychosocial model and a multiphasic approach to comply with the BOP's goal of preparing inmates for a successful reentry into the community, free from criminal and substance-abusing behaviors.

Humans↗
PubMed2003

Determining service variations between and within ASAM levels of care.

The American Society of Addiction Medicine (ASAM) Criteria Validity Study at Massachusetts General Hospital and Harvard Medical School randomized patients between programs in two levels of care. It therefore became critical to determine the extent to which programs met ASAM level of care (LOC) descriptions. Quantitative surveys (checklist) and qualitative case studies (field observation, key informant interviews) documented care variation within and between two ASAM LOCs in 12 substance abuse treatment units. These LOCs were: Level II (Intensive Outpatient Treatment) and Level III (Medically Monitored Residential Treatment). The Level II and Level III programs, as a group, met ASAM LOC criteria, but data showed major within-level variation by hours per day and number and type of skilled treatment services. Observational data suggest considerable within-level variation due to managed care and staff training. In multi-site PPC validity studies, it will be crucial to examine within-LOC variation and take into account payment sources and staff training when assessing patient outcomes.

Ambulatory Care↗
PubMed2003

The Israel Society for the Prevention of Alcoholism.

This paper describes the profile of the Israel Society for the Prevention of Alcoholism (ISPA), which is a nation-wide, public, non-profit association. It portrays various aspects of ISPA treatment and rehabilitation facilities-the residential treatment center, the rehabilitative hostel and the 'warm home' for homeless alcoholics. It depicts ISPA prevention activities, prevention materials and its usage of the media, and deals with ISPA involvement in policy issues. The paper also addresses the research reality of ISPA and its scientific journal, and refers to the society's structure and its future.

Alcoholism↗
PubMed1994

Reduction of psychopathology among individuals participating in non-treatment drug abuse residential studies.

The psychological repercussions in drug abusing individuals of their participation in non-treatment residential drug abuse research protocols have been uncertain. To study this, the average raw scores of the Symptom-Check List-90 Revised (SCL-90R) at the time of recruiting and discharge (40.2 +/- 15.6 days later) was studied at the Addiction Research Center of the National Institute on Drug Abuse (NIDA-ARC), in Baltimore, Maryland, in a sample of 233 drug abusers seeking no treatment. There was significant reduction in symptomatology (p < .01) between recruiting and discharge for Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Phobic Anxiety, Paranoid Ideation, Psychoticism, and Total Scores. These findings suggest that participation of drug abusers in non-treatment residential studies is safe and may improve their psychological status, which may be a therapeutic outcome of disengaging individuals from their drug environment and offering a safe and structured milieu.

Adult↗
PubMed1984

Behavioural assessment of disturbed, institutionalized retardates.

While behavioural assessment has had wide application in a number of educational and treatment settings, relatively little has been done to develop programmes specifically for use with retardates who have been institutionalized for the treatment of disturbed behaviour. As a result, the development of appropriate procedures for the latter group requires extrapolation from the use of behavioural techniques in other settings. The current literature on behavioural assessment stresses the importance of identifying meaningful response units and their controlling variables, if efficacious treatment programmes are to be mounted. To be maximally useful, assessment must provide a relatively simple description in objective, non-inferential terms of how a patient responds to the demands of daily living. While many reports of treatment programmes focus on the assessment of a single, narrowly defined variable, the occurrence of which can be readily counted, this is not appropriate for the initial assessment procedures of a residential treatment centre. What is required is an omnibus approach which samples the patient's responses to a broad array of environmental situations which are relevant to the centre and its population. A review of available behavioural scales reveals that there are very few reliable omnibus scales available for use with retardates and none which adequately assesses the behavioural concommitants of disturbed retardates. To deal with this group of patients, it is proposed that, initially, two scales be used to sample both normal and maladaptive behaviour. A number of suggestions have been made for implementing behavioural assessment procedures in residential treatment centres, especially for disturbed retardates.

Activities of Daily Living↗
PubMed2004

Cross-validation of the alcohol and cannabis use measures in the Global Appraisal of Individual Needs (GAIN) and Timeline Followback (TLFB; Form 90) among adolescents in substance abuse treatment.

AIMS: To examine the comparability, reliability and predictive validity of two instruments used to assess alcohol use and dependence: the Global Appraisal of Individual Needs (GAIN) and the Form 90 Timeline Followback (TLFB) method. DESIGN, SETTING AND PARTICIPANTS: Adolescents (n = 101) admitted to a residential treatment program in the United States were interviewed at intake with the GAIN, and again within a week with a variation of TLFB, called Form 90. Alcohol and cannabis measures were compared and used to predict the number of past-month substance abuse and dependence symptoms. MEASUREMENT: Self-report measures of days of alcohol and cannabis use in the 90 days prior to intake, peak number of drinks/joints used, peak blood alcohol content (BAC) and alcohol and cannabis abuse and dependence symptom counts. FINDINGS: Results revealed that the measures had: (a) excellent comparability (r = 0.7-0.8) across the two instruments; (b) deteriorating reliability after reported peak BAC levels exceeded 0.50 and peak joints exceeding 19; and (c) similar and strong relationships between use measures and the number of abuse/dependence symptoms across measures and instruments. CONCLUSIONS: In a sample of 101 adolescents who were admitted to residential treatment for alcohol or drug dependence, the corresponding measures from the two instruments produced comparable results. If the cross-validation of these two measures generalizes to adolescents treated in out-patient settings and other adolescent treatment populations, the GAIN and Form 90 may provide useful core alcohol measures for meta-analyses.

Adolescent↗
PubMed2000

Pathways to housing: supported housing for street-dwelling homeless individuals with psychiatric disabilities.

OBJECTIVE: This study examined the effectiveness of the Pathways to Housing supported housing program over a five-year period. Unlike most housing programs that offer services in a linear, step-by-step continuum, the Pathways program in New York City provides immediate access to independent scatter-site apartments for individuals with psychiatric disabilities who are homeless and living on the street. Support services are provided by a team that uses a modified assertive community treatment model. METHODS: Housing tenure for the Pathways sample of 242 individuals housed between January 1993 and September 1997 was compared with tenure for a citywide sample of 1, 600 persons who were housed through a linear residential treatment approach during the same period. Survival analyses examined housing tenure and controlled for differences in client characteristics before program entry. RESULTS: After five years, 88 percent of the program's tenants remained housed, whereas only 47 percent of the residents in the city's residential treatment system remained housed. When the analysis controlled for the effects of client characteristics, it showed that the supported housing program achieved better housing tenure than did the comparison group. CONCLUSIONS: The Pathways supported housing program provides a model for effectively housing individuals who are homeless and living on the streets. The program's housing retention rate over a five-year period challenges many widely held clinical assumptions about the relationship between the symptoms and the functional ability of an individual. Clients with severe psychiatric disabilities and addictions are capable of obtaining and maintaining independent housing when provided with the opportunity and necessary supports.

Adult↗
PubMed2002

Effects of distraction on treadmill running time in severely obese children and adolescents.

OBJECTIVE: (1) To examine the effects of attentional distraction on running time in an incremental treadmill test in obese youngsters; (2) to investigate whether distraction works at the same extent at the beginning and at the end of residential treatment; and (3) to explore the underlying mechanisms of the possible distraction effects. METHODS: Thirty severely obese youngsters (10 boys, 20 girls, age range 9-17) who were following a 10 month residential treatment, performed a treadmill test until exhaustion in four different sessions using a within subjects design. The two sessions at the beginning of the treatment and the two sessions at the end the treatment were counterbalanced, one with attentional distraction (music) and one without distraction. RESULTS: Obese youngsters ran significantly longer during distraction. This distraction effect seemed to be larger at the beginning compared to at the end of obesity treatment. The absence of differences between the condition with music and the condition without music on perceived bodily symptoms is in line with the idea that it took longer to perceive sufficient bodily sensations to decide to stop the treadmill test in the distraction condition. This interpretation is further corroborated by the physiological data indicating a superior peak performance in the condition with distraction. CONCLUSIONS: Attentional distraction has a positive effect on perseverance in obese youngsters. Further research has to show the usefulness of attentional distraction as a technique to increase exercise adoption and adherence in obesity treatment.

Adolescent↗
PubMed2000

Inpatient opiate detoxification in Geneva: follow-up at 1 and 6 months.

The aim of this study was to identify predictors of treatment success and of relapse, 1 and 6 months after inpatient opiate detoxification in an 8-bed unit in Geneva. Of all 73 patients admitted between June 1994 and June 1995, a majority (73%) successfully finished opiate detoxification. Detoxification was performed mainly with methadone tapering; the average duration of hospitalisation was 15 days. Factors associated with treatment failure were: cocaine abuse, presence of legal problems, and short duration of hospital stay. After 1 month, 65% of the patients were using drugs (half of them were dependent again, half of them had used occasionally) and 35% were completely abstinent (21% when excluding those in residential treatment). Predictors of rapid relapse were cocaine abuse and little concern with own psychological situation at baseline. After 6 months, 50% were physically dependent again, 13% had lapsed occasionally, 37% were abstinent (28% when excluding those in residential treatment). Only high benzodiazepine use at baseline was associated with medium term abstinence. Addiction severity index composite scores had considerably improved between baseline and 6 months. Prevention of relapse to opiate use after inpatient detoxification, especially for those with a concurrent cocaine abuse, should be improved.

Adolescent↗
PubMed2006

The self-report of Andi.

This fictional account of a teenage girl's treatment is based on the author's experience of working with troubled young people. He shows how cases of self-harm and antisocial behaviour can be helped not only by an understanding of the intra-psychic world, but by a therapeutic regime based on psychodynamic principles. In residential treatment there are opportunities for adolescents to learn from relationships with staff, peers and educational input but sometimes they are wasted by the repetition of abuse. While psychoanalytic psychotherapy by itself may be insufficient for a young person in need of a more comprehensive residential treatment, nevertheless psychodynamic concepts may make significant contributions to the process of therapeutic change.

Antisocial Personality Disorder↗
PubMed2001

How capitated mental health care affects utilization by youth in the juvenile justice and child welfare systems.

Examine the impact of Colorado's Medicaid mental health carve-out program on children in child welfare and juvenile justice systems. Medicaid claims and encounter data for two experimental managed care sites and one comparison fee-for-service site are used to estimate a two-part model of inpatient, outpatient, and residential treatment center utilization, controlling for patient characteristics. The study finds that juvenile justice and child welfare populations were more strongly affected by managed care than the general youth population, regarding reduced utilization of inpatient and outpatient services. Increases in Residential Treatment Centers use were greater for juvenile justice than either the child welfare sample or the total sample. Youth in child welfare increase utilization of outpatient services. Most utilization effects are stronger for not-for-profit than for-profit managed care organizations. The experience of Colorado implies that a mental health carve-out affects patterns of care for youth and differentially so for youth in juvenile justice and child welfare systems. Controlling for population characteristics, the effects are stronger for not-for-profit than for-profit managed care organizations.

Adolescent↗
PubMed2000

A comparison of sexually abused and non-sexually abused adolescents in a clinical treatment facility using the MMPI-A.

OBJECTIVE: In the current study, the adolescent version of the Minnesota Multiphasic Personality Inventory, the MMPI-A, was used to address concerns voiced about the mixing of different developmental ages, use of inadequate comparison groups, and the lack of reliance on reliable and valid measures of psychological, behavioral, and psychosocial problems used in previous studies of sexually abused children and adolescents. METHOD: A total of 107 adolescents in residential treatment (73 boys and 34 girls) were included in the study. Seventy-two of these adolescents had reportedly been sexually abused (42 boys and 30 girls); 35 had not been abused (31 boys and 4 girls). Predictions based on previous research with adolescents were made and tested regarding which MMPI-A validity, clinical, and content scales would differ between the sexually abused and non sexually abused groups of adolescents. RESULTS: Overall, and consistent with many predictions, sexually abused adolescents had both statistically and clinically higher elevations on several MMPI-A scales than did their non-abused counterparts. No scales were more elevated for non-abused adolescents than for abused adolescents. CONCLUSIONS: Sexually abused adolescents in residential treatment, as a group, present with concerns that their non-abused counterparts did not have, or did not share to the same extent. Treatment recommendations based on the MMPI-A scale elevations are provided, limitations of the current study discussed, and directions for further research are suggested.

Adolescent↗
PubMed1993

Health care utilization and costs after entry into an outreach program for homeless mentally ill veterans.

OBJECTIVE: This study evaluated the impact of a Department of Veterans Affairs outreach and residential treatment program for homeless mentally ill veterans on utilization and cost of health care services provided by the VA. METHODS: Veterans at nine program sites (N = 1,748) were assessed with a standard intake instrument. Services provided by the outreach program were documented in quarterly clinical reports and in residential treatment discharge summaries. Data on nonprogram VA health service utilization and health care costs were obtained from national VA data bases. Changes in use of services and cost of services from the year before initial contact with the program to the year after were analyzed by t test. Multivariate analyses were used to examine the relationship of these changes to indicators of clinical need and to participation in the outreach program. RESULTS: Although utilization of inpatient service did not increase after veterans' initial contact with the program, use of domiciliary and outpatient services increased substantially. Total annual costs to the VA also increased by 35 percent, from $6,414 to $8,699 per veteran per year. Both clinical need and participation in the program were associated with increased use of health services and increased cost. Veterans with concomitant psychiatric and substance abuse problems used fewer health care services than others. CONCLUSIONS: Specialized programs to improve the access of homeless mentally ill persons to health care services appear to be effective, but costly. Dually diagnosed persons seem especially difficult to engage in treatment.

Adult↗
PubMed1999

Drug abuse treatment outcome study of adolescents: a comparison of client characteristics and pretreatment behaviors in three treatment modalities.

OBJECTIVES: The present study presents background and pretreatment characteristics of adolescent substance abuse treatment clients, and it provides a mechanism for describing perhaps the largest research sample of adolescents who were in drug treatment in this decade. METHODS: The sample was 3382 subjects who presented for treatment from 1993 to 1995 in 37 programs in Pittsburgh. Pennsylvania: Miami, Florida; Minneapolis, Minnesota; Chicago, Illinois; Portland, Maine; and New York City, New York. Informed permission for the youth to participate was obtained from the subject's custodial parent/guardian, and both the youth and the youth's parents or guardians provided informed assent if they agreed to participate as subjects. Adolescents then were interviewed privately and confidentially by a trained professional interviewer who was independent of the treatment programs. The interviews queried subjects about their background, including education and employment; physical and mental health; use of tobacco, alcohol, and other drugs; sexual experiences; legal problems: religious beliefs; and treatment experience. RESULTS: The long-term residential treatment modality was the least gender balanced of the modalities and had the most African-American and Hispanic clients. This modality was distinguished by the proportion of clients who were referred to treatment by the juvenile or criminal justice system. Compared with other clients in other modalities, short-term inpatient clients were more likely to be female and white. Inpatient clients also reported more indicators of psychiatric impairment. Outpatient clients were slightly younger than clients in the other modalities, and more of them were attending school at the time of admission to treatment. Outpatient clients had the least criminally involved lifestyles, their rates of (regular daily or weekly) drug use were also the lowest of the three modalities for all drugs assessed, and they had the least drug treatment experience. CONCLUSIONS: These results merit several recommendations. One is the need for more community-based adolescent substance abuse treatment programs. An additional recommendation is for more substance abuse treatment programs in facilities that serve incarcerated youth. Finally, and perhaps most critically, it is recommended that programs be designed to address such specialized issues as comorbid substance abuse and psychiatric problems, family dysfunction, physical and sexual abuse, gender and ethnic differences, and academic performance.

Adolescent↗