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Results for “RESIDENTIAL TREATMENT”

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PubMed1999

Personality dimensions and substance misuse: relationships in adolescents, mothers and fathers.

The research addressed the question of whether relationships exist between personality dimensions, antisocial behavior, and alcohol or other substance misuse (AOSM) in adolescents and in their fathers and mothers, who often also have histories of AOSM. One hundred male adolescents (mean age 15.8 years) entering a residential treatment center for youths with AOSM, their mothers (n = 88, mean age 39.4 years), their fathers (n = 36, mean age 44.9 years), and community controls (n = 100 adolescents, mean age 16.5 years; n = 96 mothers, mean age 43.8 years; n = 87 fathers, mean age 45.9 years) were recruited. All participants completed a personality questionnaire and were interviewed on several measures, including structured interviews for psychopathology and substance misuse. The findings indicated that novelty seeking (NS), one of the personality dimensions, was significantly correlated with substance misuse in adolescent probands, adolescent controls, and proband fathers and mothers, but not in control fathers and mothers. Regression analyses that included conduct disorder (CD) or antisocial personality disorder (APD) symptoms indicated that both NS and CD or APD symptoms made significant contributions to the prediction of substance misuse in treatment group probands and in their fathers and mothers. The findings further suggest that NS and antisocial behaviors contribute independently to substance misuse in severely impaired adolescents and their fathers, but not in their mothers.

Adolescent↗

PubMed1996

Strategies for follow-up of drug users: field research guidelines.

The timely follow-up of clients who exited from two residential treatment programs was achieved by the consistent application of the described strategies. The enrollment and treatment phases of the study provided the environment for the use of standard follow-up and enhanced outreach methods. The applicability of the strategies to a variety of settings makes the prioritization of the follow-up methods presented a meaningful one. The role of the researcher in the reevaluation of follow-up protocols within an ethical context is discussed.

Cost-Benefit Analysis↗

PubMed1980

The underlife of behavior modification.

The practice of behavior modification in a residential treatment center for emotionally disturbed children is described, based on the author's observations over 18 months. Particular attention is given to the influence of context and situation as staff members count units of behavior, report their findings, and meet with colleagues to evaluate their data. It is suggested that these data reflect a mixture of client behavior and tacit staff practices, although they are presented officially as being only about clients.

Affective Symptoms↗

PubMed1982

Response of patients with chronic pain to exercise quotas.

The effects of setting exercise quotas were examined using 26 subjects with chronic pain. The subjects were participants in a residential treatment program. Each subject was assigned a group of exercises to perform twice daily. A single subject multiple baseline design across responses was used to evaluate treatment effects. The data analysis revealed that the subjects responded to quotas by showing steady and gradual increases in exercise activity. These effects, however, occurred only when quotas were set and were not generalized from "quota" to "nonquota" exercises. These data were discussed in terms of the usefulness of exercise quotas, the applicability of multiple baseline designs, and the need for more research in the area of generalization.

Adult↗

PubMedDate not supplied

Burning their bridges: disordered attachment and foster care discharge.

An ethnographic study of boys in residential treatment reports on a small subsample of older adolescents diagnosed with conduct disorder. Attachment theory and research inform the basis for analysis of the study's observations. Findings indicate that conduct-disordered out-of-home care drifters display exceptionally clear patterns of alienation in relation to transitions from placement to placement. Implications of the findings for care and discharge planning are discussed.

Activities of Daily Living↗

PubMed1999

Psychiatric features of 36 men convicted of sexual offenses.

BACKGROUND: To increase understanding of the relationship between sexual violence and mental illness, the authors assessed the legal histories and psychiatric features of 36 males convicted of sexual offenses. METHOD: Thirty-six consecutive male sex offenders admitted from prison, jail, or probation to a residential treatment facility received structured clinical interviews for DSM-IV Axis I and II disorders. The participants' legal histories, histories of sexual and physical abuse, and family histories of psychiatric disorders were also assessed. RESULTS: The participants' mean +/- SD age was 33+/-8 years. They had been convicted a mean of 1.8+/-1.4 times (range, 1-9 times) for sexual offenses and incarcerated a mean of 8+/-6 years (range, 0-22 years). Participants displayed high rates of lifetime DSM-IV Axis I disorders: 30 (83%) had a substance use disorder; 21 (58%), a paraphilia; 22 (61%), a mood disorder (13 [36%] with a bipolar disorder); 14 (39%), an impulse control disorder; 13 (36%), an anxiety disorder; and 6 (17%), an eating disorder. Participants also displayed high rates of Axis II disorders, with 26 (72%) meeting DSM-IV criteria for antisocial personality disorder. In addition, subjects reported experiencing high rates of sexual (but not physical) abuse and high rates of Axis I disorders, especially substance use and mood disorders, in their first-degree relatives. Compared with subjects without paraphilias, subjects with paraphilias displayed statistically significantly higher rates of mood, anxiety, and eating disorders, as well as significantly higher rates of childhood sexual abuse. CONCLUSION: Recognition and treatment of major psychiatric disorders among sex offenders may increase chances for successful rehabilitation, reduce recidivism and public victimization, and produce significant public health and economic benefits. More studies in this area appear warranted to search for more effective interventions for this severe public health problem.

Adolescent↗

PubMed2005

Differences in impulsivity and risk-taking propensity between primary users of crack cocaine and primary users of heroin in a residential substance-use program.

Crack cocaine use is more associated with impulsivity and a propensity to take risks than heroin use, yet no studies have examined this relationship in the absence of acute drug effects. The current study examined impulsivity (using the Delay Discounting Task) and risk-taking propensity (using the Balloon Analogue Risk Task) across independent groups of primary crack cocaine users with minimal heroin use (n = 16) and primary heroin users with minimal crack cocaine use (n = 11) in residential treatment, with all participants drug abstinent during participation. Crack cocaine users evidenced greater levels of impulsivity and risk-taking propensity, with only the difference in impulsivity persisting after controlling for age and gender. These data hold potential theoretical importance in understanding differences between crack cocaine and heroin users, as the findings cannot be attributed solely to acute pharmacological drug effects.

Age Factors↗

PubMed1976

Body build and behavior in emotionally disturbed Dutch children.

Some physique-behavior relations were determined in 75 boys and 51 girls, aged 6 to 14, in a residential treatment center in Holland. Each child's behavior was rated by four group workers on a checklist yielding eight summary scores. Physique was judged from nude photographs for manifest endomorphy, mesomorphy, and ectomorphy. While a number of moderate-sized relations appeared in zero-order and multiple correlations, canonical analysis showed two significant, independent sets of relations between physique and behavior in the boys, one in the girls. Among the boys, one set related mesomorphy and energy level, the other related primarily ectomorphy with unsocialness, excitability, and cooperativeness. Among the girls, these same behaviors were compressed in a single set, primarily relating energy level but also unsocialness, excitability, and cooperativeness positively with mesomorphy and negatively with endomorphy and ectomorphy. Compared with findings on the same instrument in a sample of normal American preschoolers, many individual associations were similar, despite differences in culture and language, age, intelligence, social status, adjustment, and residential setting of the S's.

Adolescent↗

PubMed1998

Intellectual evaluations of adolescents via human figure drawings: an empirical comparison of two methods.

The human figure drawings of 200 adolescent boys were collected at a residential treatment center in a midsized, midwestern city. The drawings were scored for cognitive ability according to the systems of Buck (1966) and Goodenough and Harris (1963). Both scoring systems showed acceptable interrater reliability and both were positively and significantly related to IQ scores on the Wechsler Intelligence Scale for Children-Revised. Buck's system, however, had less of a tendency to underestimate IQ scores. Buck's system may therefore hold greater promise for the intellectual assessment of adolescents with human figure drawings.

Adolescent↗

PubMed1976

The validity of self-recording reports made by drug and alcohol abusers in a residential setting.

In this study a self-recording procedure was used to clarify the relationship between urges or cravings for drugs (including alcohol) and actual drug (including alcohol) use within a residential setting. There were two purposes of the study: first, to evaluate the predictive validity of the self-recording procedure; and second, to generate empirical data relevant to the concept of craving, which is crucial to many theories of drug and alcohol addiction. The predictive validity of the urge reports was evaluated using a behavioral measure--actual and suspected drug use incidents. These incidents were reported by staff members on all drug and alcohol abusers in residential treatment during a 2-month period. The results indicate that there is no significant tendency for there to be an increased use of drugs on the same days that drug urges are reported, and that drug use incidents are most likely associated with reports of no urges for drugs. Therefore, the predictive validity of the self-recording reports was not established. The data challenge the notion that drug usage is preceeded by or accompanied by (intense, driving) drug cravings at least within this setting.

Adult↗

PubMed1992

Clinicians and research: recurring obstacles and some possible solutions.

We surveyed clinicians in residential treatment centers (RTCs) to explore their perceptions of barriers to and resources for accomplishing research and scholarly pursuits. A nationwide sampling of RTCs generated a sample of 273 respondents, which consisted of 95 psychologists, 27 psychiatrists, and 151 social workers. Our sample of clinicians expressed very favorable attitudes toward research and the scientist-practitioner model. However, the great majority are not combining the roles of clinician and researcher/scholar. The most frequently cited barriers to scholarly activity were insufficient time, research not part of the job description, and lack of funding. Recommendations are offered.

Attitude of Health Personnel↗

PubMed1981

Rorschach cards IV and VII revisited.

Using 67 emotionally disturbed children and adolescents in residential treatment, the "father-mother" hypothesis of Cards IV and VII of the Rorschach technique was investigated. While Cards X and IV were selected significantly often, it was only Card IV which was selected as the "father" card significantly more often than chance, as well as significantly less often selected as the "mother" card. Conversely, Card VII was selected as the "mother" card significantly more often than chance and selected as the "father" card significantly less often. The more dysfunctional a child or adolescent's relationship is with his/her parents, the more likely the child/adolescent selects Card IV as the "father" or Card VII as the "mother" card. Implications are discussed.

Adolescent↗

PubMed2006

Magnetic resonance imaging volumetric analysis of the putamen in children with ADHD: combined type versus control.

OBJECTIVE: Volumetric differences in the putamen of boys with ADHD combined subtype with psychopathic traits and controls are investigated. METHOD: The putamen in 24 archival magnetic resonance imaging scans of 12 boys in residential treatment with symptoms of ADHD and psychopathic traits and 12 community control boys are analyzed using Display software. RESULTS: There are no differences found in the total, left, and right putamen volumes across the ADHD or control group. A significant reversal of asymmetry across groups is found; children with ADHD more frequently have a smaller left putamen than right. In contrast, the control group more frequently has a smaller right than left putamen. CONCLUSION: A reversal of symmetry in the putamen (as found in the caudate) may relate to ADHD symptomology as well as to psychopathic traits.

Adolescent↗

PubMedDate not supplied

Using dance/movement therapy to augment the effectiveness of therapeutic holding with children.

PROBLEM: Therapeutic holding is a commonly used tool for the containment of aggressive behavior in children. Although often effective, the intervention has inherent physical and emotional safety risks. Can a body-based therapy be used to limit these risks? METHODS: Research was conducted incorporating dance/movement therapy techniques (D/MT) before and after therapeutic holding to investigate this question. Volunteer residential treatment center staff participated in a 4-hour D/MT-based training workshop integrating the techniques with the intervention. Children participated via self-report. FINDINGS: D/MT training increased adult awareness, sensitivity, perspective shifting ability, and confidence in the intervention while decreasing the necessity for physicality. CONCLUSION: Integrating D/MT therapy training with therapeutic holding decreased the threat of trauma to adult participants. Further research into the integration of D/MT techniques with safe holding procedures may prove helpful in the challenge of making restraints safer for both children and adults.

Adaptation, Psychological↗

PubMed1991

A descriptive study of abuse and neglect in out-of-home-placement.

Selected characteristics of 290 reports of physical abuse, sexual abuse and neglect in foster homes, group homes, residential treatment centers, and institutions are described. At each type of setting physical abuse reports were most common, and neglect reports were least common. Quantitative and qualitative methods demonstrate that a significant percentage of confirmed reports are of a serious nature. Injuries occurred most frequently because of physical abuse while sexual abuse reports were most likely to be confirmed. Prior allegations of abuse or neglect regarding the perpetrator were indicated in 27% of reports. Factors contributing to abuse and neglect and the role of a state institutional review team in developing a systematic approach to this problem are discussed.

Adolescent↗

PubMed2001

Neuroleptic-related dyskinesias in children and adolescents.

BACKGROUND: Few studies have investigated the comparative risk of neuroleptic-related dyskinesias in children and adolescents receiving typical versus newer, atypical antipsychotics. This prospective study was completed to test whether clinical use of atypical antipsychotics is associated with less risk for developing neuroleptic-related dyskinesias than clinical use of typical neuroleptics in an unselected heterogeneous population of seriously emotionally disturbed youths admitted to acute residential treatment. We also tested a novel model of predictive risk for neuroleptic-related dyskinesias in children and adolescents. METHOD: 102 children and adolescents receiving typical neuroleptics, atypical antipsychotics, or the combination were studied. Youths developing neuroleptic-related dyskinesias were compared with youths free of dyskinesias over a 3-month study period on demographic, diagnostic, and treatment variables. Logistic regression was utilized to develop a novel model of predictive risk. RESULTS: Of neuroleptic-treated youths, 5.9% had probable tardive dyskinesia, a rate less than the prevalence of tardive dyskinesia in chronic neuroleptic-treated adults. Use of typical neuroleptics was significantly (p = .03) associated with dyskinesia compared with use of atypical antipsychotics. Four variables including IQ, initial Abnormal Involuntary Movement Scale score, type of antipsychotic, and cumulative number of risk factors accounted for 35.8% of the variance when predicting dyskinetic status. CONCLUSION: Use of atypical antipsychotics appears to be associated with less dyskinesia risk than typical neuroleptics in an unselected group of seriously emotionally disturbed children and adolescents. Results support a cumulative risk model of neuroleptic-related dyskinesia in youths.

Adolescent↗

PubMed2004

Staff supervision in residential care.

Residential care workers must be offered opportunities for formalized and systematic supervision in individual and group formats to provide the highest possible level of care to children and adolescents whom they serve. Effective supervision with residential care staff should be open to exploring issues at all levels of their experience and in relation to each component of the broader organizational structure within which they work. Systems theory offers a useful lens through which to view supervising staff in residential treatment. Systems theory proposes that human behavior is shaped by interactional processes and internal factors. Although the development of the individual occurs within intrinsic cognitive and emotional spheres, it also is believed to be related to several other elements. These additional variables include the point at which the family and system function in their own life cycle, the historical and current emotional context, the current and changing structure of the system, narratives, and the cultural context. This article discussed how methods of training and supervision would be most effective if they were designed specifically for the developmental level of the participants. Some literature reviews have concluded that youth care workers, like all professionals, pass through developmental stages and progress through them in their work. To assist youth care workers in their jobs, supervisors must understand these stages and the ways in which they may be enacted in the workplace.

Adolescent↗

PubMed1990

A cognitive/affective empathy training program as a function of ego development in aggressive adolescent females.

This study investigated the effects of an affective/cognitive empathy training program on level of empathy in 24 aggressive adolescent females in a residential treatment center. In addition, the relationship between empathy and level of ego development was explored. Empathy was defined as a psychological construct regulated by both cognitive and affective components, interacting in a systemic manner to produce emotional understanding. Subjects were pretested on measures of affective empathy, cognitive empathy, and Loevinger's scale of ego development. High and low scores on the measures of ego development were defined by a median split. Following random assignment to groups, experimental subjects were exposed to four 1.5-hour training sessions directed at increasing levels of affective and cognitive empathy. Posttests revealed significant positive relationships between ego development and both measures of empathy. Training significantly increased levels of affective empathy, while increases in cognitive empathy were unremarkable. There was no difference between high and low ego development scorers in their ability to profit from training. The hypothesized systemic relationship between affective and cognitive empathy was also supported by the findings.

Adolescent↗