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Results for “RESIDENTIAL TREATMENT”

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PubMed1980

The use of a correctional setting for follow-up care of psychiatrically disturbed adolescents.

The authors studied the first 88 adolescents boys who were placed on the secure unit of a correctional school during an 18-month period and found that 52 (59.1%) of the boys had previously received psychiatric residential treatment or psychiatric hospitalization. The authors hypothesize that many of these boys may have been transferred from a psychiatric setting to a correctional facility during adolescence when long-standing aberrant behaviors became more threatening to staff. At present the number of psychiatric hospital beds is decreasing and the criteria for hospitalization of children are becoming more stringent. The data indicate that correctional facilities are now expected to function as psychiatric treatment centers for disturbed adolescents no longer welcome in therapeutic settings.

Adolescent↗

PubMed1994

Prediction of recreational therapy behavior of hospitalized adolescents from a behavior classification instrument.

The purpose of this study was to estimate the validity of an instrument of the Adolescent Behavioral Classification Project in predicting behavior patterns of emotionally disturbed adolescents in an inpatient setting. Subjects (n = 126) were adolescents admitted to a state residential treatment unit across a period of 35 months. Predictor variables were scores on 17 or 25 factors of the instrument from both adolescents' own responses and their mothers' responses on their behalf. Criterion variables were 10 recreational therapy factors, especially 4 temporally stable factors, and length-of-time in treatment. 3 phases of the project were (I) behavior during initial stages of the therapy, (II) behavioral change after 3 months of therapy, and (III) length-of-time in treatment. In Phase I, both mothers' and adolescents' responses produced significant correlations with criteria; however, in Phase II only the adolescent students' 25 ABCP factors predicted behavioral change. In Phase III, adolescents' responses but not their mothers' responses classified the adolescents by length-of-time in treatment.

Adolescent↗

PubMed1979

Gestalt therapy in a social psychiatric setting: the 'oil & water' solution.

In this case study, a provincial government residential treatment center for mentally and emotionally disturbed adolescents, used Gestalt Therapy as its primary therapeutic and staff-development ideology. Based on participant observation, document analysis, source material Survey on Gestalt Therapy, staff-sample interview and patient sample (of diagnostic, socioeconomic status and intelligence) data, it was demonstrated that Gestalt Therapy was neither designed nor intended for treatment of young adolescents manifesting severe psychiatric or behavioral disorders, for people from lower socioeconomic status families, or of low verbal skill and intelligence. It was discovered that a disporportionately large number of the case study population were: young adolescents, from lower socioeconomic status families, and that a significant proportion were of low verbal skill and intelligence. It was further suggested th,t Gestalt criteria for: physical environment, behavioral expectations (on staff and patient) and group-living ideology were incompatible with professional, legal and treatment expectations in an institutional treatment setting.

Adolescent↗

PubMedDate not supplied

Residential substance abuse treatment for pregnant and postpartum women and their children: treatment and policy implications.

In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.

Adult↗

PubMed1999

Substance abuse history predicts depression and relapse status among cocaine abusers.

This study examined the relationships between lifetime years of cocaine, alcohol, and marijuana use prior to entry into residential treatment for primary cocaine dependence and (a) intake depression levels, and (b) levels of cocaine use in the six months after completing treatment. Years of education, age, and lifetime years of cocaine and alcohol use contributed significantly to predicting depression levels. Lifetime years of alcohol use alone predicted cocaine use during the six months post-treatment.

Adult↗

PubMedDate not supplied

The Atwood Hall Health Promotion Program, Federal Medical Center, Lexington, KY. Effects on drug-involved federal offenders.

There is a critical need for the development of effective substance abuse and dependence treatment programs in prisons and jails. One aspect of treatment provision within this population that has received insufficient research attention is the inclusion of health promotion or wellness programs, including exercise and other health-related lifestyle modification training. Little is known about either the physiological or psychological consequences of such lifestyle modification programs among prisoners with substance use disorders. This study reports the effectiveness of an experimental wellness program included as part of a residential treatment unit in a federal correctional institute in the United States. A sample of 43 female offenders with a history of polysubstance abuse or dependence, who had volunteered to be part of a residential drug treatment program, were evaluated. Changes in health status and perceived psychological well-being between entry into the program and exit after maintaining participation for a minimum of 9 months were assessed. Pretest-posttest comparisons on a variety of physiological parameters indicated that significant improvements had occurred in the physical fitness of the group. Thematic analysis of qualitative self-reports by inmates exiting the program suggested that participants had also experienced significant enhancements in a number of areas pertaining to psychological well-being, including self-esteem, health awareness and concerns, healthy lifestyle adoption, and relapse prevention skills. These results suggest that including health promotion training in drug treatment programs for incarcerated offenders may have beneficial results.

Alcoholism↗

PubMed1999

Planning to meet the needs of offenders with mental disorders in the United Kingdom.

During the last decade the planning of services for offenders with mental disorders in the United Kingdom has been geared toward diverting them from the criminal justice system to appropriate levels of psychiatric and social care. Although a seamless service system is yet to be developed, the central government has made a concerted effort to promote a better understanding of the needs of offenders with mental disorders and encourage collaboration between the relevant agencies. A major program of research has been initiated, and local health authorities have been encouraged to use a consortium approach to planning and delivery of specialist services. The authors discuss the activities of the Wessex consortium, composed of five local health authorities and a social services department serving a catchment area with a population of 2.5 million in southern England. The consortium has commissioned needs assessments for all offenders with mental illness from the catchment area and a survey of the resources for secure residential treatment in the region. Based on data from this research, the consortium is planning the development of two long-stay secure units to accommodate offenders with a history of repeated inpatient and prison stays and poor response to previous treatment and rehabilitation efforts.

Commitment of Persons with Psychiatric Disorders↗

PubMed1998

The application of traditional martial arts practice and theory to the treatment of violent adolescents.

Components of an effective treatment program for violent adolescents, and the complex problems posed by youth gangs, are discussed. It is proposed that traditionally taught martial arts can provide a useful alternative for such dysfunctional adolescents. The literature on the use of martial arts in the treatment of violence is reviewed, and the program philosophy is described. The program utilizes a commitment to respect and self-control, with an emphasis on leadership and community service using the traditional model of a gentle warrior. Oversight is provided by trained instructors, whose psychological and philosophical approach stresses nonviolence. The program also assists youths in coping with the complexities of an often dysfunctional family environment. Clinical examples detail the application of such a program in specialized martial arts schools, residential treatment, and public school classes.

Adolescent↗

PubMed2002

Goodness-of-fit processes for logistic regression: simulation results.

In this paper we use simulations to compare the performance of new goodness-of-fit tests based on weighted statistical processes to three currently available tests: the Hosmer-Lemeshow decile-of-risk test; the Pearson chi-square, and the unweighted sum-of-squares tests. The simulations demonstrate that all tests have the correct size. The power for all tests to detect lack-of-fit due to an omitted quadratic term with a sample of size 100 is close to or exceeds 50 per cent to detect moderate departures from linearity and is over 90 per cent for these same alternatives for sample size 500. All tests have low power with sample size 100 to detect lack-of-fit due to an omitted interaction between a dichotomous and continuous covariate, while the power exceeds 80 per cent to detect extreme interaction with a sample size of 500. The power is low to detect any alternative link function with sample size 100 and for most alternative links for sample size 500. Only in the case of sample size 500 and an extremely asymmetric link function is the power over 80 per cent. The results from these simulations show that no single test, new or current, performs best in detecting lack-of-fit due to an omitted covariate or incorrect link function. However, one of the new weighted tests has power comparable to other tests in all settings simulated and had the highest power in the difficult case of an omitted interaction term. We illustrate the tests within the context of a model for factors associated with abstinence from drug use in a randomized trial of residential treatment programmes. We conclude the paper with a summary and specific recommendations for practice.

Computer Simulation↗

PubMed1979

Social-ecological assessment of environments: toward a two-factor model.

A study was conducted to test the usefulness of the two-factor model in assessing social environments. Subjects were residents and staff at a residential treatment center for emotionally disturbed and/or delinquent boys and girls. Rating instruments consisted of (a) two parallel versions of Moos' Community-Oriented Programs Enivronment Scale (COPES), each worded so as to be appropriate to the setting being measured, and (b) global ratings of satisfaction with the environment. Principal component factor analyses, carried out separately on the youths' COPES-School and the youths' COPES-Cottage, yielded two orthogonal but similar factors in each environment. In a comparison with Moos' three-dimensional formulation of the social milieu, the two factors strongly resembled two of Moos' dimensions but were more independent, had greater validity, and discriminated between the two environments at a higher level of significance. The instruments derived from the factor analyses provide a simple procedure for assessing a variety of treatment programs and populations.

Adolescent↗

PubMed1979

Juvenile firesetters: do the agencies help?

In an attempt to find out what was being done for juvenile firesetters in their metropolitan community the authors reviewed the records of the local fire marshal, juvenile court, and psychiatric clinic. They found that the various agencies involved with 69 juveniles over a 3-year period were unable to coordinate their efforts and were largely unsuccessful in controlling the firesetting. Because the families of firesetters seem to have many other social problems, the authors recommend early inpatient assessment and possible referral to foster homes or residential treatment settings for juvenile firesetters.

Adolescent↗

PubMed1983

Psychiatry and juvenile law.

This article discusses new developments in the field of forensic child psychiatry as they apply to hospitalization and residential treatment, child custody and divorce, juvenile delinquency, competency, and malpractice.

Adolescent↗

PubMed2004

Relationship between drug treatment services, retention, and outcomes.

OBJECTIVE: This longitudinal study conducted path analyses to examine the relationships between treatment processes and outcomes among patients in community-based drug treatment programs. METHODS: A total of 1,939 patients from 36 outpatient drug-free and residential treatment programs in 13 California counties were assessed at intake, discharge, three months after admission, and nine months after admission. Path analyses were conducted to relate the quantity and quality of services that were received in the first three months of treatment to treatment retention and outcomes at the nine-month follow-up. Patients were determined to have a favorable outcome if for at least 30 days before the follow-up assessment they did not use drugs, were not involved in criminal activity, and lived in the community. The path analyses controlled for patients' baseline characteristics. RESULTS: Greater service intensity and satisfaction were positively related to either treatment completion or longer treatment retention, which in turn was related to favorable treatment outcomes. Patients with greater problem severity received more services and were more likely to be satisfied with treatment. These patterns were similar for patients regardless of whether they were treated in outpatient drug-free programs or residential programs. CONCLUSIONS: The positive association between process measures-that is, greater levels of service intensity, satisfaction, and either treatment completion or retention-and treatment outcome strongly suggests that improvements in these key elements of the treatment process will improve treatment outcomes.

Adolescent↗

PubMed1990

Patterns of runaway behavior within a larger systems context: the road to empowerment.

Runaway behavior is a common problem in residential treatment settings for youth. This paper looked at Orten and Soll's runaway typology and Homer's conceptualization of runaways as "running from" or "running to" something and expanded the context to include interactions with family and professionals. A case study and a survey of nine adolescent runaways from a residential setting were used to explore several hypotheses. A discussion of the results and practical applications illustrated ways to empower therapists and other professionals to deal with runaways more effectively.

Adolescent↗

PubMed1998

Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: results from the analysis of administrative data.

This study tests a typology of homelessness using administrative data on public shelter use in New York City (1988-1995) and Philadelphia (1991-1995). Cluster analysis is used to produce three groups (transitionally, episodically, and chronically homeless) by number of shelter days and number of shelter episodes. Results show that the transitionally homeless, who constitute approximately 80% of shelter users in both cities, are younger, less likely to have mental health, substance abuse, or medical problems, and to overrepresent Whites relative to the other clusters. The episodically homeless, who constitute 10% of shelter users, are also comparatively young, but are more likely to be non-White, and to have mental health, substance abuse, and medical problems. The chronically homeless, who account for 10% of shelter users, tend to be older, non-White, and to have higher levels of mental health, substance abuse, and medical problems. Differences in health status between the episodically and chronically homeless are smaller, and in some cases the chronically homeless have lower rates (substance abuse in New York; serious mental illness in Philadelphia). Despite their relatively small number, the chronically homeless consume half of the total shelter days. Results suggest that program planning would benefit from application of this typology, possibly targeting the transitionally homeless with preventive and resettlement assistance, the episodically homeless with transitional housing and residential treatment, and the chronically homeless with supported housing and long-term care programs.

Adult↗

PubMed2005

Ecological Assessment of Substance-abuse Experiences (EASE): findings from a new instrument development pilot study.

A newly developed instrument that assesses a client's orientation to addiction or recovery communities using social context referents was pilot tested with a sample of 103 adults seeking treatment for substance abuse at outpatient and residential treatment facilities on the East Coast. Preliminary findings show promising subscale reliabilities, and suggest that drug- and recovery-related social identities are related to drug-use severity and drug-use concern; and drug-related attitudinal congruence between the treatment-seeker and family and treatment-seeker and other significant persons are related to intention to make behavioral changes in reducing substance abuse.

Adolescent↗

PubMed1998

Children's and adolescents' perception of their asthma bronchiale.

The present study examines the perception of asthma bronchiale in a large sample of 382 children and adolescents (mean age = 12.5 years) across three different treatment settings (outpatient, short-term rehabilitation, residential treatment) by using a revised child version of the 'Asthma Problem Behavior Checklist.' A PCA reveals two factors (eigenvalues: 26.3; 4.2; 0.9 ..) with a complementary structure: 'appraisal of asthma-related distress' (explained variance: 48.5%) and 'appraisal of resources in coping with asthma-related distress' (explained variance: 20.9%). Implications for clinical psychological assessment of young patients with asthma and the congruence with the LAZARUS transactional conceptualization of stress and coping are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Effects of treatment history and centralized intake on drug treatment outcomes.

This study assesses differences between first-time treatment clients (n=90) and repeat treatment clients (n=361), including whether entering treatment through a central intake unit affects outcomes differently for the two groups. Interview data were collected at baseline, one-month and 12-month follow-up. Study groups were similar in gender, race and age, but repeat treatment participants were more educated, more likely to primarily use heroin and more likely to have ever injected drugs. First-time treatment clients were more likely to have been required to enter treatment, but less likely to have applied to another program or to be in the program they desired. First-time treatment clients were also more likely to be in outpatient or day treatment, and less likely to be in residential treatment. Problem severity decreased for both groups over time, with no significant differences between groups. There was one significant interaction effect of study group and length of stay on social problem severity, such that longer stays in treatment led to a greater reduction in social problems for repeat treatment clients. Route of treatment entry (CIU/non-CIU) was not associated with problem severity nor change in problem severity over time for either study group.

Adult↗