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PubMed1982

Performance of delinquent and nondelinquent high schools boys on the Rotter Incomplete Sentence Blank.

This study compared 30 delinquent adolescent boys who had been placed in a residential treatment center with 30 randomly selected high school boys on the Rotter Incomplete Sentence Blank (Rotter). For each group a maladjustment score was computed. The results indicated a significant difference between the two groups' mean maladjustment scores on the Rotter. A cut-off score was established that made it possible to correctly identify 73% of the normals and 60% of the residential treatment group. An item analysis was carried out between the two groups to see whether certain sentence stems discriminated between the two groups. Fourteen sentence stems were found to discriminate significantly between the groups. From these sentence stems a short form of the Rotter was established with a revised maladjustment score that correctly identified 82% of the boys in each group. A cross-validation of the short form with 48 high school boys and 67 delinquents supported its use as 75% of the high school boys and 80% of the delinquents were correctly identified.

Adolescent↗
PubMed2001

Access to inpatient or residential substance abuse treatment among homeless adults with alcohol or other drug use disorders.

OBJECTIVES: We conducted a theoretically guided study of access to inpatient or residential treatment among a probability sample of homeless adults with alcohol or drug use disorders in Houston, Texas. METHODS: This study used a cross-sectional, retrospective design with data collected from a multistage random sample of 797 homeless adults age 18 or older who were living in Houston shelters and streets in 1996. Structured, face-to-face interviews produced screening diagnoses for alcohol and drug use disorders, treatment use data, and candidate predictors of treatment use. Logistic and linear regression analyses were performed on the subset of 326 homeless persons with either alcohol or drug use disorder. RESULTS: 27.5% of persons with substance use disorder had accessed inpatient or residential treatment during the past year. Controlling for additional need factors such as comorbidity, persons having public health insurance and a history of treatment for substance problems had greater odds of receiving at least one night of treatment. Contrary to expectation, contact with other service sectors was not predictive of treatment access. Schizophrenia and having a partner appeared to hinder access. Greater need for treatment was associated with fewer nights of treatment, suggesting retention difficulties. CONCLUSIONS: This study adds to previous findings on access to health care among homeless persons and highlights a pattern of disparities in substance abuse treatment access. Health insurance is important, but enhancing access to care involves more than economic considerations if homeless persons are to receive the treatment they need. Referral relationships across different service sectors may require strengthening.

Adult↗
PubMed1990

Rubella immunity in chemically dependent adolescent females.

Congenital rubella syndrome continues to be a problem in this country because of the continued existence of a substantial susceptibility to rubella in young women of childbearing age. The objectives of this study were to determine the percentage of chemically dependent adolescent women in a residential treatment center at risk for rubella infection and to correlate their immune status with history of immunization. Although only one individual was reported as not having been vaccinated for rubella, 12.4% of the 129 subjects were found to be nonimmune by titer. No statistical relationship was found between self- or parent-reported immunization status and actual titer finding. Of the 16 women found to be not immune, only 56% were successfully vaccinated. Patient history appears to be of little value in establishing immunization status in this population. We recommend vaccination of young women in residential treatment centers who do not have documented histories of vaccination.

Adolescent↗
PubMed2005

Youth with problematic sexualized behaviors in the child welfare system: a one-year longitudinal study.

This study assessed continuity of problematic sexualized behaviors (PSB) over a 1-year period. Ninety-seven 10-12-year-olds in either foster boarding homes or a residential treatment center participated at Time 1. Twelve months later, 78 youth were available for a second data collection assessment. At both data collection phases, researchers interviewed foster parents or primary therapists about the youths' sexual behavior. Findings revealed significant continuity in PSB over time, with children who at Time 1 exhibited PSB significantly more likely to exhibit PSB at Time 2. The reverse was also true in that the absence of PSB at Time 1 was associated with the absence of PSB at Time 2. In addition, a subset of specific PSB behaviors was noted to be most stable, although this varied across the groups. Youth with PSB exhibited several patterns of persistence in specific behaviors over time, including continuity, a mix of continuity and change, and complete discontinuity. The persistence of PSB over time was most true for the children living in a residential treatment center, the more disturbed group studied. We conclude that the persistence of PSB is more likely when the child has other problematic behaviors.

Child↗
PubMedDate not supplied

Residential drug abuse treatment research: are conventional control designs appropriate for assessing treatment effectiveness?

There has been renewed interest in residential drug abuse treatment research since the late 1980s. Earlier research employed control group designs. This article argues that for today's treatment research, the applicability of control groups created by either matched groups or by random sampling is limited. Four difficulties with control group designs are (1) client differences make assembling matched treatment and control groups untenable, (2) implementing random designs is practically impossible in field research, (3) there are ethical, political, and legal dilemmas in withholding treatment from a control group, and (4) randomly selected client populations will behave differently from the more realistic treatment circumstance involving client populations who are selected based on need and motivation. A more applicable perspective for drug abuse treatment research than the control group design needs to recognize that the client influences the treatment as well as that the treatment influences the client. Also, it must be understood that most clients view residential treatment as only one aspect of their life. Most importantly, individual differences must be taken into account when predicting outcome. A perspective that incorporates these concepts can use client history or baseline as its no-treatment comparative condition, and make use of multivariate analyses to help account for many other influences on outcome.

Humans↗
PubMed1993

Overview of mental health services provided by state adult correctional facilities: United States, 1988.

State-by-State data concerning the administrative auspices, volume of use, and sources of funding and expenditures for mental health services in adult correctional facilities are reported for 1988 from the first national survey of prison mental health services conducted by the Center for Mental Health Services. In all States reporting, a total of 11,546 State prison inmates--about 25 per 1,000--were receiving 24-hour psychiatric inpatient or residential treatment care for a psychiatric disorder on September 30, 1988. During the month of September 1988, nearly 10 percent of State prison inmates (95.6 per thousand) received some form of mental health counseling or psychotherapy from a physician, nurse, psychologist, or social worker; about 5 percent (49.7 per thousand inmates) received monitoring or evaluation of a psychotropic medications regimen; and about 4 percent (41.7 per thousand inmates) received psychiatric assessment or psychological testing to determine their mental health or emotional status. In the majority of States, 24-hour mental health care was provided in a mix of psychiatric and prison hospital settings, both on and off prison grounds, through interagency agreements, or through a mix of interagency and contractual arrangements. Individual State figures vary widely on these characteristics, as well as on length of stay for 24-hour hospital and residential treatment care, both within and among auspice types.

Adult↗
PubMed1984

Improving the record-keeping performance of direct service personnel.

Record review procedures and contingent performance feedback were used to monitor and improve the record-keeping performance of human service staff in a behavioral residential treatment setting. A multiple baseline design was employed across three groups of B.A.-level human service personnel. The study consisted of five conditions: (1) Baseline 1; (2) Written Instructions (memoranda); (3) Written Performance Feedback; (4) Verbal Performance Feedback; and (5) Baseline 2 (return to the Baseline 1 condition). Dependent measures included highly reliable ratings by independent observers of the (1) essential documents present in case records, (2) documents approximately located/organized in case records, and (3) an overall rating of documents present, correctly organized, signed and dated, and not duplicated in the records. Results indicated that the procedures most frequently used to provide feedback to human services personnel--meetings, policy and procedure manuals, and/or written memoranda--were not as effective as verbal feedback sessions in prompting staff participation in case record maintenance. Findings were interpreted to suggest that, with adequate training, supervision, and performance appraisal, direct service personnel in residential treatment settings can effectively manage clients' case records and become more involved in, and committed to, accountability and quality control.

Employee Performance Appraisal↗
PubMedDate not supplied

Treatment foster care services: a research agenda for child welfare.

Treatment foster care is a recent and rapidly expanding multisystem service. This article summarizes the empirical literature on treatment foster care and offers suggestions for future research directions. Results from program evaluations and experimental research suggest that treatment foster care is an effective alternative to residential treatment for seriously troubled and troubling children. The research has lacked rigorous controls regarding the populations served, however, as well as the critical components of interventions used in treatment foster care that produce positive results for the children. Integration with pertinent research findings from other disciplines is also necessary because of the multisystemic needs of the diverse population of children served in treatment foster care.

Caregivers↗
PubMed2003

A comparison of Caribbean and non-Caribbean clients in a residential addiction treatment facility in Antigua, West Indies.

The first 50 Caribbean clients admitted to a private, multicultural, not for profit addiction treatment center in Antigua, West Indies, were compared with the first 100 non-Caribbean clients admitted. There was no significant difference in age, 38 years (18-61 years) versus 40 years (22-63 years), or gender, 74% versus 67% male. Caribbean clients were more likely to be Black, 68% versus 2%, P < .001. Caribbean clients were less likely to have a prior psychiatric diagnosis, 18% versus 43%, P < .01, or to have been in prior treatment program, 22% versus 64%, P < .001. Caribbean and non-Caribbean clients were equally likely to be polydrug users, 48% versus 50%, and to use alcohol as a primary drug, 52% versus 51%. Caribbean clients were more likely to use cocaine, 30% versus 11%, P < .01, and marijuana, 12% versus 0%, P < .001, but less likely to use heroin, 6% versus 30%, P < .001 or pills, 0% versus 8%, P < .05. Caribbean clients were less likely to have elevated MCV, 24% versus 57%, P < .001 or serum transaminases, 23% versus 46%, P < .01. Differences between groups in this multicultural setting warrant further investigation.

Adolescent↗
PubMed2004

The importance of need for cognition and educational experience in enhanced and standard substance abuse treatment.

The current study examined the relationship between need for cognition (i.e., cognitive motivation or "will") and educational experience (i.e., cognitive ability or "skill") to perceived improvements during treatment of probationers receiving residential treatment within the criminal justice system. Probationers were randomly assigned to either receive motivational activities developed by the authors (the "enhanced" condition), or treatment as usual (but with access to general reading materials in lieu of the motivational activities). Need for cognition and educational experience were assessed and used as blocking variables, and ratings of progress were assessed midway and toward the end of treatment. The results indicate that both need for cognition and educational experience are important predictors of improvement during treatment, and that the motivational activities developed by the authors were particularly valuable for clients with lower levels of need for cognition.

Adult↗
PubMedDate not supplied

Measuring nonmedical psychiatric treatment interventions with statistical software.

This article addresses, from both research and political perspectives, the issue of quantifying data on nonmedical psychiatric treatment activity in large residential treatment settings. It presents a method of collecting this type of data that includes the use of readily available statistical software. It describes the methodology in detail and examines the variables. The system has had an impact on treatment, administration, and personnel at the facility.

Ancillary Services, Hospital↗
PubMed1999

Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments.

This article reviews the outcome (usually abstinence at 12 months) of 21 controlled studies of AA, with emphasis on methodological quality. Severe selection biases compromised all quasi-experiments. Randomized studies yielded worse results for AA than nonrandomized studies, but were biased by selection of coerced subjects. Attending conventional AA meetings was worse than no treatment or alternative treatment; residential AA-modeled treatments performed no better or worse than alternatives; and several components of AA seemed supported (recovering alcoholics as therapists, peer-led self-help therapy groups, teaching the Twelve-Step process, and doing an honest inventory).

Alcoholics Anonymous↗
PubMed1995

[Borderline developmental disorders in children--on theory and treatment].

The author characterizes so called "borderline-children" on the basis of 190 case-studies referring to the results of a survey of some 100 child therapists and 40 child psychiatrists. "Borderline-children" show severe psycho-social strain and traumatic experiences and can be characterized by discrepant development, narcissistic pathology, aggressively and impulsiveness, clinging relationships as well as contact problems with children of the same age. The therapy aims at helping children to continue their development at a level appropriate to their age. Due to anxieties and hectic acting out, the therapy has to set distinct boundaries from the very beginning. Regression has to be curbed, archaic fantasies are to be copied with at a metaphorical level by play therapy and not interpreted by the therapist so that dissociated conscious matter is bridged. Usually the social environment has to be integrated into the treatment. In some cases. residential treatment and pharmacotherapy are necessary.

Adolescent↗
PubMed2004

Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies.

The effectiveness of residential substance abuse treatment for women was examined using data from the Center for Substance Abuse Treatment's Residential Women and Children/Pregnant and Postpartum Women (RWC/PPW) Cross-Site Study and two other recent national studies. Treatment success was defined as posttreatment abstinence from further drug or alcohol use, measured through in-person follow-up interviews conducted 6-12 months after each client's discharge. Despite differences in treatment programs, client profiles, follow-up intervals, data collection methods, and other factors, all three studies found high treatment success rates--ranging narrowly from 68% to 71% abstinent--among women who spent six months or more in treatment. Success rates were lower, and between-study differences were larger, for clients with shorter stays in treatment. Controlling for salient client and treatment project characteristics, strong associations between length of stay in treatment and posttreatment abstinence rate were found in all three studies, suggesting that women's length of stay in residential treatment is a major determinant of treatment effectiveness. In further analysis of RWC/PPW data, treatment completion was also found to be an important outcome factor. Among clients who remained in treatment for at least three months, those who achieved their treatment goals in three to five months abstinence outcomes were as good as those for clients who took more than six months to complete their treatment (76%-78% abstinent) and substantially better than those for clients who did not complete treatment (51%-52% abstinent). Notably, however, most of the RWC/PPW clients who successfully completed treatment (71%) required six months or more to do so.

Adult↗
PubMed2006

Impact of victimization on substance abuse treatment outcomes for adolescents in outpatient and residential substance abuse treatment.

This paper considers whether victimization moderates adolescents' outcomes in substance abuse treatment. Adolescents (N=975) in outpatient and residential settings were assessed at intake, three, six, nine, and 12 months. Differential outcomes by gender and degree of victimization were analyzed. Dependent variables were marijuana use and substance-related problems. The residential sample reported higher baseline marijuana use and victimization. Both samples significantly reduced marijuana use and associated problems during treatment. Victimization was significantly related to more substance-related problems at intake and follow-up. More severe trauma histories in residential females were associated with significantly greater persistence in substance-related problems post-discharge.

Adolescent↗