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Results for “RESIDENTIAL TREATMENT”

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At least 577 records · Page 32Linked to original sources

PubMed2001

The use of node-link mapping in the chemical dependency treatment of adolescents.

The current study examined treatment perceptions of youth adjudicated to an eight-month residential treatment facility. Participants were randomly assigned to standard or mapping-enhanced counseling. They completed established questionnaires assessing group sessions, program features, treatment motivation, and number of program infractions. Mapping residents rated group sessions as deeper over time. Mapped sessions appeared to also maintain residents' arousal over time. Mapping residents rated themselves as more motivated to get along with staff, and also tended to be more motivated to engage in the treatment process. In addition, mapping residents had fewer program infractions thirty days after the beginning of the experiment compared to standard residents. These findings extend previous research on node-link mapping in adult treatment settings.

Adolescent↗

PubMedDate not supplied

Milieu management of traumatized youngsters.

TOPIC: Traumatized youngsters are disproportionately represented in out-of-home treatment facilities. Conceptual models that guide treatment of traumatized youngsters are not well integrated with models that guide milieu management. PURPOSE: To describe a milieu management approach for treatment of traumatized youngsters. SOURCES: Clinical experience with hospital and residential treatment facilities and therapeutic foster homes, as well as literature support. CONCLUSIONS: Familiar treatment strategies take on an additional meaning when they are implemented in the context of the children's histories of exposure to traumatic events.

Child↗

PubMedDate not supplied

Arts-based therapies in the treatment of eating disorders.

Arts-based therapies are increasingly being employed, in conjunction with empirically valid traditional therapies, in the residential treatment of eating disorders. A systematic database search of arts-based therapies in the treatment of eating disorders was conducted. In addition, program staff at 22 residential eating disorder treatment programs were contacted to provide information regarding arts-based therapy utilization rates. Of the 19 programs that participated in this study, all incorporate arts-based therapies on at least a weekly basis in the treatment of eating disorders. However, while published narrative reflections on arts-based therapies and eating disorders imply a generally positive outcome, no known, empirically valid studies exist on this experiential form of therapy within the area of eating disorders.

Art Therapy↗

PubMedDate not supplied

Cultural connection and transformation: substance abuse treatment at Friendship House.

This research investigates the transformational experiences of Native Americans during the course of their retraditionalization and treatment for drug and alcohol dependence. Twelve graduates of the residential treatment program at Friendship House in San Francisco were interviewed about the kind and quality of their healing experiences in this particular program which provides a comprehensive matrix of Native American medicine as well as Western models of psychological treatment. The purpose of this study was to understand and document the experience of substance abuse recovery from the perspective of the Native Americans in treatment. Twelve themes emerged from the data analysis: feeling cared for; spiritual experience; insight; making a commitment; empowerment/self-esteem; releasing emotional pain; remorse; reconnecting to traditional values; forgiveness; relief; safety; and gratitude.

Acculturation↗

PubMed1993

Treatment evaluation of alcoholism: non pharmacological interventions.

The approach of alcoholism treatment is most frequently multidisciplinary. Beside pharmacological approaches exist a lot of psychotherapeutic and psycho-social treatments. What are the advances in outcome research in these fields: residential treatments, self-help groups, brief interventions, psychotherapies? What is the current status in psychotherapy research and what is the specificity of psychological interventions for alcoholic patients? In this paper we shall make some clarifications on these questions, and we'll show that we need further research with controlled studies of patient-treatment matching.

Alcoholism↗

PubMed1990

Structured outpatient treatment of alcohol vs. drug dependencies.

This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.

Adolescent↗

PubMed1999

Reductions in criminality subsequent to group, individual, and family therapy in adolescent residential and day treatment settings.

The complete population of adolescents in a residential and day-treatment program over a 4-year period, 532 youths, served in two studies. Along with residential and day-treatment settings, predictive variables of interest were the number of hours spent in group, individual, and family therapy. A total of 227 adolescents qualified for Study 1 which found a reduction of rates of criminal charges from pre- to posttreatment. Study 1 also found that hours in group therapy explained the most variance in the reduction in rates of criminal charges, followed closely by hours in individual therapy. Hours in family therapy was not a significant predictor. A total of 430 adolescents qualified for Study 2, which found that residential treatment was associated with greater reductions in adult correctional commitments than day treatment. Implications stress the need for further research examining the relationships between therapeutic components of residential treatment and behavioral outcomes.

Adolescent↗

PubMed1990

Inpatient psychiatric treatment of children and adolescents: a review of outcome studies.

All outcome studies of child and adolescent residential treatment and inpatient psychiatric hospitalization reported in the literature from 1975 to the present were examined. A set of statistical procedures was developed to integrate the findings of the 34 studies, which provided a weighted predictive value for 10 variables. Psychiatric hospitalization was often beneficial, particularly if a specialized treatment program and aftercare were available and if the child presented with a less pathological clinical picture. Age at admission and sex bore no relationship to favorable outcome, and IQ and length of stay yielded only a modest relationship to outcome. Recommendations to guide future researchers are offered that will provide new insights into better understanding inpatient psychiatric treatment.

Adolescent↗

PubMed1995

Race in the treatment of homeless mentally ill veterans.

A multi-site descriptive outcome study examined differences between black and white veterans in admission characteristics, program participation, and outcomes following an episode of treatment in a Veterans Affairs residential program for homeless veterans with psychiatric and substance abuse problems. Admission, discharge, and 6-month and 12-month postdischarge follow-up data were collected on 119 black and 144 white veterans admitted to the Domiciliary Care for Homeless Veterans Program at three sites. Chi-square tests and t-tests were used to identify differences between racial groups at admission. Factorial repeated-measures analysis of covariance was then used to identify differences between black and white veterans in improvement, controlling for differences that were significant at the time of admission. On admission, blacks were younger and had more problems with drugs and violent behavior, but were less likely than whites to have clinical diagnoses of alcohol abuse or a serious psychiatric disorder, and had fewer suicide attempts. They also had more social contacts and had more frequently experienced a recent disruption in an important relationship. Few differences were found between the two racial groups in measures of program participation. One year after discharge, both black and white veterans had improved in virtually all domains. Black veterans showed greater improvement in medical symptomatology, social contacts, and violence, while white veterans showed a greater increase in outpatient health service use. While both black and white veterans benefitted from participation in residential treatment, the data suggest that blacks were more likely to re-establish previously disrupted social ties while whites increased their involvement in the VA health care system.

Adult↗

PubMed2006

Adolescent inhalant use among male patients in treatment for substance and behavior problems: two-year outcome.

UNLABELLED: Adolescent inhalant users are significantly more likely than other patients to have conduct disorder, to report abuse and neglect, and to have previously attempted suicide. Yet little has been published regarding treatment outcome for inhalant users. METHODS: Eighty male adolescents admitted to a residential treatment program underwent baseline assessment during treatment, and follow-up assessment at two-years post admission. Subjects reporting any lifetime inhalant use at baseline (n = 34) were compared to the other patients (n = 46) on 4 outcome variables. RESULTS: Adolescents reporting any lifetime inhalant use at baseline assessment reported twice as many past-year conduct disorder symptoms at two-year follow up (p = 0.03). The relationship between inhalant use and conduct disorder symptoms remained significant (p = 0.03) in analyses that controlled for age, time in jail or restricted environments in the 6-months preceding follow-up, as well as baseline-reported lifetime number of conduct disorder symptoms. Inhalant users were not significantly worse on these other outcome measures: crime in the last month (p = 0.60), days of nontobacco substance use in the last 6 months (p = 0.65), or, commission of selected crimes in the last 6 months (p = 0.06). CONCLUSIONS: Inhalant use among adolescent males in treatment for substance and behavior problems may predict more severe conduct disorder symptoms after treatment.

Administration, Inhalation↗

PubMed2003

[Chronic Alcoholics with Multiple Impairments]

To improve reliability of diagnosis of a specific subgroup of chronic alcoholics with multiple impairments (CMA), operational criteria have been proposed. To evaluate usability and sensitivity vs. specifity, all in-patients fulfilling ICD-10 criteria of alcohol dependence were screened on two randomly chosen dates. Two clinically "extreme" groups were extracted: patients in a 8-week short-term residential treatment vs. patients in a residential program specifically designed for chronic alcoholics with severe somatic, psychic and/or social consequences. More quantitative operational criteria, such as "treatment experience" and "consumptive behaviour" revealed much lower discriminative power than more qualitative criteria, such as "comorbidity" and "social and legal status". Substantially revised and simplified operational criteria exhibited comparable sensitivity and specifity for the classification of chronic alcoholics with multiple impairments (CMA).

Journal Article↗

PubMed2003

[Chronic alcoholic patients with multiple comorbidity. Community outpatient evaluation of a recommendation for operationalized diagnosis and alternative models].

To improve reliability of diagnosis of a specific subgroup of chronic alcoholics with multiple impairments (CMA), operational criteria have been proposed. To evaluate usability and sensitivity vs. specificity, all in-patients fulfilling ICD-10 criteria of alcohol dependence were screened on two randomly chosen dates. Two clinically "extreme" groups were extracted: patients in a 8-week short-term residential treatment vs. patients in a residential program specifically designed for chronic alcoholics with severe somatic, psychic and/or social consequences. More quantitative operational criteria, such as "treatment experience" and "consumptive behaviour" revealed much lower discriminative power than more qualitative criteria, such as "comorbidity" and "social and legal status". Substantially revised and simplified operational criteria exhibited comparable sensitivity and specificity for the classification of chronic alcoholics with multiple impairments (CMA).

Alcoholism↗

PubMed1993

Residential versus day treatment for children: a long-term follow-up study.

Adults and adolescents, who as children, received day or residential treatment were followed up ten years after treatment completion. No differences were found between the two treatment modalities on follow-up ratings of personal and social adjustment. This pattern was not influenced by gender, IQ, or presenting problem. Overall, about two-thirds of the children demonstrated improvement at follow-up. As expected, individuals demonstrating higher levels of personal and social adjustment at initial assessment were functioning better at outcome. However, the magnitude of therapeutic gain was not significantly different for mild versus moderate-to-severe presenting problems. Suggestions for future research are included.

Adolescent↗

PubMed1991

The de facto national system of psychiatric inpatient care. Piecing together the national puzzle.

National data regarding psychiatric inpatient episodes can be viewed in 2 ways. The normative method surveys the "specialty mental health sector." A more inclusive method includes smaller sites (e.g., the military), all of general hospital treatment (rather than only the psychiatric unit), residential treatment centers, and other residential care. The difference between the 2 methods represents approximately 725,000 episodes, at a direct cost of more than $6 billion. The more inclusive analysis of the years 1980 and 1985 reveals a strong shift to the private sector and an increase in inpatient care of children and youth that might be obscured by limiting national treatment statistics to the specialty mental health sector.

Cost Control↗

PubMed2003

Drug and alcohol treatment among privately insured patients: rate of specialty substance abuse treatment and association with cost-sharing.

OBJECTIVE: To examine the rate of formal substance abuse (SA) treatment in a privately insured population, and the association between cost-sharing, residential treatment, and outpatient SA treatment, we analyzed claims data for 332442 adults in 41 health plans with comprehensive SA treatment benefits. DESIGN: SA treatment utilization during 1999 and the relationship between patient cost-sharing, gender, and SA diagnosis on SA treatment utilization were examined using a cross-sectional retrospective analysis. RESULTS: Only 0.37% (n=1230) of adults had a SA related claim during 1999. Individuals in plans with higher levels of cost-sharing had lower rates of residential SA treatment and specialty SA outpatient treatment compared to individuals in plans with lower cost-sharing, adjusting for age, sex, and SA diagnosis. CONCLUSIONS: Few individuals had SA related claims, raising questions about rates of undocumented treatment, out-of-network treatment, and unmet need for treatment in the privately insured, and its implications for assessing the quality of SA treatment available in private health plans. At a time when levels of cost-sharing are increasing among privately insured individuals, consideration should be given the potential impact of such changes on the treatment of individuals requiring specialty SA treatment.

Adult↗

PubMedDate not supplied

Service-level costing of drug abuse treatment.

This paper presents a methodology for estimating costs of delivering specific substance abuse treatment services. Data collected from 13 programs indicate that the mean cost of residential treatment is $2,773 per patient per month, and outpatient treatment costs average $636 per patient per month. Data are presented on the cost patient per month for individual treatment and nontreatment services, average number of services, cost per unit of service, and intensity of services. In addition to their application to insurance benefit cost estimation, these data illustrate the costing of best-practice adolescent treatment consistent with a Center of Substance Abuse Treatment (CSAT) Treatment Improvement Protocol. In the emerging policy environment, detailed cost estimates like these will aid the design of cost-effective treatment programs, and serve the development of the substance abuse benefit in a health care reform insurance package.

Adolescent↗

PubMed1980

Peer managed token economies: evaluation and description.

Evaluated peer Managed Token Economy Programs (TEP) to determine their effectiveness in influencing patients' behaviors on the treatment unit and psychosocial adjustment as rated by treatment staff. Two experiments were conducted with adult patients (N = 56) in a residential treatment program. The first study indicated that patients' ward behaviors were maintained at a satisfactory level by either a special peer managed or staff managed TEP. An identical program that operated with non-contingent reinforcement, however, was shown to result in dramatic decrements in patients' ward behavior. The second experiment compared two peer managed token economy programs, one that operated with a group incentive and one with an individual incentive orientation. Results indicated that both of these programs effectively maintained patients' daily ward performance, reduced psychological problems, increased social adequacy, and enhanced community adjustment potential. The relative advantages and potential uses of peer managed programs were discussed.

Adult↗

PubMed2003

Multiple opportunities for creating sanctuary.

This article describes the experience of five change agents from a diverse group of settings: two residential treatment programs for children and adolescents, a group home for disturbed adolescents, a residential substance abuse program for urban women, and an acute care psychiatric inpatient unit. What all of these innovators share is a willingness to engage in the challenging and complex process of changing their systems to better address the needs of the traumatized children, adolescents, and adults who populate their various programs. Using the Sanctuary Model as originally applied to a specialty inpatient psychiatric program for adult survivors of childhood abuse as their guide, the leaders of each of these organizations discuss the process of change that they are directing.

Adolescent↗