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Results for “RESIDENTIAL TREATMENT”

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PubMed2005

Correlates of motivation to quit smoking among alcohol dependent patients in residential treatment.

Substance use and smoking co-occur at high rates and substance abusers smoke more and have greater difficulty quitting smoking compared to the general population. Methods of increasing smoking cessation among alcoholics are needed to improve their health. This study investigated predictors of motivation to quit smoking among patients early in residential treatment for substance abuse. The 198 alcohol dependent patients were participating is a larger smoking study at an inner-city residential substance abuse treatment program. Motivation was measured by the Contemplation Ladder. A hierarchical multiple regression was conducted to assess whether perceived barriers to smoking cessation and self-efficacy about quitting were associated with motivation to quit smoking independent of the influence of degree of tobacco involvement, substance use, and comorbid depressive symptoms. Motivation was higher with longer previous smoking abstinence, fewer barriers to quitting, and greater self-efficacy but was not influenced by smoking rate, dependence, or gender. While the combination of alcohol and drug use, alcohol and drug problem severity, and depressive symptoms predicted motivation, no one of these variables was significant. Since barriers to change and self-efficacy are potentially modifiable in treatment, these could be salient targets for intervention efforts. This could be integrated into treatment by assessing barriers and providing corrective information about consequences and methods of overcoming barriers and by providing coping skills to increase confidence in one's ability to quit smoking.

Adult↗
PubMed2003

Changes in fat mass, fat-free mass and aerobic fitness in severely obese children and adolescents following a residential treatment programme.

UNLABELLED: The purpose of this study was to describe changes in fat mass (FM), fat-free mass (FFM) and aerobic fitness in severely obese children and adolescents during residential treatment in the Medical Paediatric Centre Zeepreventorium. Treatment consisted of moderate dietary restriction, physical activity and psychological support. This study was a clinical observation of 20 severely obese children and adolescents (8 boys and 12 girls, aged 15.4+/-1.8 years) who completed the 10-month residential programme. Height, weight, FM, FFM and aerobic fitness was measured four times during the intervention: at baseline, 11 weeks, 24 weeks and at 33 weeks (at the end of the programme ). The mean decrease in level of overweight was 46% (P<0.001), with a mean loss of 8.9% FM (P<0.001). Submaximal performance (PWC150) improved from 123+/-35 Watt to 152+/-37 Watt (P<0.001). Maximal performance levels increased (performance time: from 14+/-2.9 min to 15.3+/-3.5 min, peak power: from 186+/-38 Watt to 205+/-45 Watt, P<0.01) without an improvement in absolute VO(2 peak). CONCLUSION: A moderate dietary restriction in combination with physical activity and psychological support in severely obese children and adolescents is effective in decreasing body fat and improving physical performance. Further research is needed to evaluate the longer-term effects of such a programme.

Adipose Tissue↗
PubMedDate not supplied

Covariates of length of stay in residential treatment.

This study explores variables associated with length of stay in a child welfare residential treatment center. The study followed three entry cohorts (416 boys) from admission through discharge. The researchers conducted event history analyses to examine the rates of discharge over time and the covariates of length of stay. They conducted analyses by discharge destination (reunified, transferred, or ran away). The results demonstrated that mental health issues slowed down rates of discharge for youth who were reunified or transferred. For children who left by running away, age and prior substance history were associated with faster rates of exit. These results have important public policy implications for improving the application of length of stay variables in planning and treatment.

Adolescent↗
PubMedDate not supplied

Integrating special-needs adoption with residential treatment.

Current estimates indicate that 76% of Iowa children whose parents' rights have been terminated and who are listed on the adoption exchange are older children with emotional/behavioral disabilities. Residential treatment can play a significant role in preparing difficult-to-place children (e.g., seven- to 14-year-olds with moderate to severe emotional or behavioral problems) for adoptive placement [Powers and Powell 1982]. The SATT model offers the opportunity to effectively manage the risks in adoptive placement for these children.

Adoption↗
PubMed1990

The effectiveness of various degrees and circumstances of program completion of young male offenders in a residential treatment center.

Boys admitted to a treatment facility do not always complete their treatment. This study analyzes the follow-up socialized coping of boys preponderantly classified as conduct disordered who were admitted to a residential treatment center. The boys were categorized into 10 different groups, only 1 of which consisted of those who actually completed treatment. The differences between groups and subsequent coping were fairly pronounced and highly significant. Further analysis indicated that very few of the group differences could be attributed to either age at admission or duration of treatment. Data analysis supported the hypothesis of treatment effectiveness in that boys who completed treatment did better in general than boys who did not, although those withdrawn by their parents did best of all. Furthermore, the rather pronounced differences among groups that failed to complete treatment raised certain methodological questions with regard to the practice of aggregating such groups in evaluation research.

Adaptation, Psychological↗
PubMed1999

Previous participation in outpatient methadone program and residential treatment outcome: a research note from Hong Kong.

Methadone maintenance programs are good examples of harm-reduction efforts because heroin addicts stabilized on methadone have been found to be able to reduce illicit drug use and criminality and improve their life condition, even though they have not achieved abstinence. While excluding the criterion of abstinence allows the harm-reduction approach to distinguish itself from traditional treatment, little research attention has been paid to the relationship between methadone programs and abstinence-oriented treatment programs. This research note reports some of the findings of a study of 77 former male clients of SARDA, a voluntary residential treatment agency in Hong Kong, pertaining to such a relationship. Findings suggest that a client's previous participation in the Outpatient Methadone Program of the Department of Health could facilitate successful outcome in his subsequent participation in SARDA's treatment program and help him to continue his drug-free status in the post-SARDA treatment period. Conceptual and policy implications of the findings are discussed. [Translations are provided in the International Abstracts Section of this issue.]

Ambulatory Care↗
PubMedDate not supplied

Mentally ill chemical abusers in residential treatment programs: effects of psychopathology on levels of functioning.

Measures of psychopathology among mentally ill chemical abusers (MICAs) were examined as predictors of levels of functioning in two types of community based, residential programs: therapeutic community (TC) and community residence (CR). Non-significant associations were generally observed between scales of psychiatric symptoms (e.g., depression, psychotic ideation, cognitive disorientation, and hostility) and counselors' ratings of the residents' capacity to meet the social and interpersonal expectations of the programs (e.g., personal care, involvement in interpersonal relationships, and development of work skills). The study suggests that individuals with moderately severe psychopathology can be successfully engaged in residential treatment, even in programs with relatively high expectations for interpersonal involvement and functioning, such as the therapeutic community.

Activities of Daily Living↗
PubMedDate not supplied

Participation in community residential treatment and substance abuse patients' outcomes at discharge.

OBJECTIVE: The study sought to identify patient characteristics that predict participation in substance abuse treatment in community residential facilities (CRFs) and to examine the association between patient characteristics, participation in treatment, and outcomes at discharge from CRFs. METHODS: A sample of 2,794 patients with substance abuse disorders was assessed at entry into and discharge from a representative set of 88 CRFs nationwide. RESULTS: In general, patients' psychological distress, motivation for treatment, prior involvement in self-help, and social resources predicted more engagement in CRF services and activities; prior inpatient treatment and the history of a psychiatric disorder predicted less engagement. These patient characteristics also predicted outcomes at discharge; more important, participation in treatment was positively and independently associated with such discharge outcomes as completion of the program and moving into stable residence. In addition, there was some evidence that participation in treatment counteracted the negative effects of high-risk patient characteristics on outcome. CONCLUSIONS: Participation in treatment is as important a predictor of outcomes at discharge from CRFs as are patient characteristics at intake to treatment. Suggestions are made about how providers can enhance patients' motivation to participate and remain in treatment.

Adult↗
PubMed1999

Utilization of services for mentally ill chemically abusing patients discharged from residential treatment.

Little is known about outcomes of treatment for individuals with mental illness and chemical dependencies. This article compares services utilization preadmission and postdischarge in 534 patients discharged from a residential treatment program in Washington State. A number of services, including chemical dependency detoxification, mental health crisis, inpatient psychiatric, medical emergency, and general medical inpatient hospitalization, were used less frequently in the period after discharge. The total reimbursement for all Medicaid services decreased by 44% from $5 million in the year prior to discharge to $2.8 million in the year after discharge. Also, individuals (32%) who completed the program were less likely to use costly, acute care services. This study was limited by the absence of a control group and posttreatment alcohol and drug use data. In addition, other unmeasured factors could have explained the association between program completion and better outcomes.

Adult↗
PubMed1997

Combined pharmacotherapy in children and adolescents in a residential treatment center.

OBJECTIVE: To investigate characteristics of children and adolescents with a history of combined pharmacotherapy (CPT) and compare them with a group with no history of CPT. METHOD: Eighty-three consecutive admissions to a residential treatment center were divided into a CPT and a no-CPT group based on treatment history and compared by chart review. Prevalence of lifetime psychiatric medication use and CPT exposure were assessed. Demographic, diagnostic, treatment, behavioral, and medication variables were compared across the two groups. RESULTS: Medication use was present in the treatment history for 89.2% and a history of CPT was found for 60.3% of subjects. Admission to current placement from inpatient psychiatry, lifetime number of psychiatric placements, lifetime number of psychiatric diagnoses, and nonseizure neuropsychiatric comorbidity were significantly associated with CPT. Aggression and neuroleptic use were also significantly associated with CPT. Admission psychiatric diagnostic comorbidity was not associated with CPT. CONCLUSIONS: A high prevalence of psychiatric medication use and CPT was found in this population. Variables assessing illness severity, aggressive behavior, and nonseizure neuropsychiatric comorbidity may identify youths in psychiatric treatment settings with a high prevalence of past or current CPT exposure. Further research on the CPT of aggression is warranted.

Adolescent↗
PubMed1996

Family involvement in residential treatment.

Social policy stresses the importance of the family's continuing involvement with members in residential placement. We studied involvement of families with 163 children and adults in residential treatment and with their programs. Parent and staff reports of family involvement showed high agreement. The average family had 21 contacts annually with the family members; these related only marginally to the extent of involvement with the residents' programs. There was no evidence of detachment, a lessening of involvement over time. Multiple regression found three variables that accounted for 52% of the variance in contacts: higher involvement related to less distance from the facility, greater expectations that the family member would return home, and lower levels of mental retardation. Implications of findings for increasing family involvement were discussed.

Adolescent↗
PubMed1980

The residential treatment of a consciously rejected child: a psychoanalytic study with social and legal implications.

In this paper, we proposed to describe the residential psychiatric treatment of a consciously rejected nine year old girl and to comment on some of the major social and legal complications which so frequently accompany such cases. We will begin by describing the nature of residential treatment at Children's Psychiatric Hospital. We will then describe both the mother and the child, with an emphasis on understanding their psychopathology as well as the legal and social issues that arose during treatment. The resolution of the case is then presented, followed by recommendations which we feel are applicable to many similar cases seen at residential settings.

Child↗
PubMed1986

A psychometric evaluation of a residential treatment facility: an illustration of an interpretable research design without a control group.

This paper reports on the interim results of an evaluation study which followed a group of disordered-delinquent adolescents discharged from a long-term residential treatment program. Findings from the first cohort of adolescents tested at admission and discharge with the Tennessee Self-Concept Scale (TSCS) indicate statistically significant improvement in all the areas of self-concept, significant decreases in all areas of psychopathology, and no systematic response set at either testing. The research design is unique in that, without a control group, competing interpretations of treatment effectiveness have been ruled out. Using design features, clinical observation, and common sense, four competing explanations of the favorable results have been eliminated. Both the instrument and research design are of interest to those undertaking evaluation research in underfunded settings where control groups are difficult to obtain due to financial or logistical problems.

Adolescent↗
PubMed2003

Prevalence and characteristics of chronic pain among chemically dependent patients in methadone maintenance and residential treatment facilities.

CONTEXT: Little is known about the prevalence and characteristics of chronic pain among patients with different types of chemical dependency. OBJECTIVES: To estimate the prevalence and to examine the characteristics of chronic severe pain in chemically dependent populations receiving methadone maintenance or inpatient residential treatment. DESIGN, SETTING, AND PARTICIPANTS: Representative samples of 390 patients from 2 methadone maintenance treatment programs (MMTPs) and 531 patients from 13 short-term residential substance abuse treatment (inpatient) programs, all in New York State, were surveyed in late 2000 and early 2001. MAIN OUTCOME MEASURE: Prevalence of chronic severe pain, defined as pain that persisted for more than 6 months and was of moderate to severe intensity or that significantly interfered with daily activities. RESULTS: Chronic severe pain was experienced by 37% of MMTP patients (95% confidence interval [CI], 32%-41%) and 24% of inpatients (95% CI, 20%-28%; P =.03). Pain of any type or duration during the past week was reported by 80% of MMTP patients and 78% of inpatients. Among those with chronic severe pain, 65% of MMTP patients and 48% of inpatients reported high levels of pain-related interference in physical and psychosocial functioning. Among MMTP patients, correlates of chronic pain in a multivariate model were age (odds ratio [OR], 2.08; 95% CI, 1.17-3.70), chronic illness (OR, 1.88; 95% CI, 1.07-3.29), lifetime psychiatric illness (OR, 1.77; 95% CI, 1.06-2.97), psychiatric distress (OR, 1.63; 95% CI, 1.22-2.18), and time in treatment (OR, 2.23; 95% CI, 1.06-4.68). Among inpatients, the correlates of chronic pain were race (blacks vs whites: OR, 0.52; 95% CI, 0.31-0.90; Hispanics vs whites: OR, 0.48; 95% CI, 0.24-0.95), drug craving (OR, 2.78; 95% CI, 1.54-5.02), chronic illness (OR, 2.17; 95% CI, 1.37-3.43), and psychiatric distress (OR, 1.36; 95% CI, 1.03-1.81). Among those with chronic severe pain, inpatients were significantly more likely than MMTP patients to have used illicit drugs, as well as alcohol, to treat their pain complaint (51% vs 34%, P =.005) but were less likely to have been prescribed pain medications (52% vs 67%, P =.01). CONCLUSIONS: Chronic severe pain is prevalent among patients in substance abuse treatment, especially MMTP patients. Pain is associated with functional impairment and correlates of pain vary with the population. Self-medication for pain with psychoactive drugs appears especially problematic among substance users who enroll in drug-free treatment programs. Substance abuse treatment programs need to develop comprehensive and structured pain management programs.

Adult↗
PubMed2005

Evaluation of a voluntary, military-style residential treatment program for adolescents with academic and conduct problems.

This study evaluated the effectiveness of a military-style residential treatment program for adolescents with academic and conduct problems. Two hundred twelve referred adolescents were separated into 3 groups for analyses: (a) adolescents who completed the 22-week program, (b) adolescents who prematurely withdrew, and (c) wait-list controls. Adolescents' socioemotional and behavioral functioning were measured at baseline and 6 months after treatment. Results showed statistically and clinically significant reductions in externalizing symptoms and increases in adaptive behavior associated with treatment. Treatment was also associated with increased likelihood of high school completion or employment and decreased likelihood of alcohol or drug problems and arrest. The relation between treatment participation and outcomes was moderated by adolescents' living environments after treatment, but it was not moderated by age of symptom onset. The benefits of treatment may be partially attributable to the voluntary nature of the intervention.

Adolescent↗
PubMed2005

Voucher-based incentives for cigarette smoking reduction in a women's residential treatment program.

Participants were women (N = 16) living with their children in a residential substance abuse treatment facility. In this within-subjects repeated measures study, a 1-week baseline was followed by a 4-week intervention and a 2-week follow-up (same as the baseline). The intervention consisted of exposure to an educational video and a smoking cessation workbook, brief individual support meetings, and an escalating schedule of voucher-based reinforcement of abstinence. Throughout the study, three daily breath samples (8 a.m., noon, and 4 p.m.) were collected Monday through Friday to determine carbon monoxide (CO) concentration. In addition, urine cotinine (COT) was assessed on Monday mornings to monitor weekend tobacco use. Participants received vouchers of escalating value for CO-negative breath and COT-negative urine samples. Positive samples reset the voucher value. Significantly more negative tests were submitted during the intervention than during baseline and follow-up. The intensive behavioral intervention evaluated in this study produced a substantial reduction in cigarette smoking, and 25% of participants remained abstinent 2 weeks after the intervention was suspended. Nevertheless, the percentage of CO-negative samples submitted during the follow-up returned to baseline levels. While retaining many real-world characteristics, residential treatment facilities provide important opportunities for smoking cessation treatment and research.

Adult↗
PubMed2003

Incremental validity of the MMPI-A content scales in a residential treatment facility.

The current study explores the incremental validity of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) content scales. Participants were 335 adolescents (250 boys and 85 girls) between the ages of 13 and 18 who were receiving mental health services from a residential treatment facility. Regression analyses were conducted to identify the amount of additional variance accounted for by the content scales over the clinical scales in predicting scores on a clinician rating form of psychological symptomatology. Several of the MMPI-A content scales demonstrated significant incremental validity above the clinical scales in predicting clinician ratings of adolescents' behavior and personality characteristics. The clinical scales also demonstrated incremental validity in reference to the content scales, indicating then that the two sets of scales provide complementary information. Magnitude of the additional criterion variance predicted was modest.

Adolescent↗