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At least 19 recordsLinked to original sources
PubMed2004

Future directions in residential treatment.

Residential treatment has assumed a role in the service system of being the placement of last resort. This has been driven by various policy initiatives and trends to which the field has tended to respond with defensiveness. Experiences over the past few decades have demonstrated that the issue for residential programs is not simply the survival of an important service for seriously troubled children and their families, but rather the development of a new paradigm for residential treatment's role in community service systems. This paradigm involves residential treatment programs and the a more proactive stance with local, statewide, and national partners, helping to create integrated systems of care, implement outcome measurement, and create family- and community-centered programming.

Adolescent↗
PubMed2004

Legal issues in residential treatment.

Residential treatment centers face increasingly complex legal issues in the current environment. For example, this article described some of the complex federal and state requirements related to the preservation of confidentiality and the conditions under which the breaking confidentiality is permitted. A general summary of informed consent requirements was presented. With respect to confidentiality and consent issues, the intricate web of rights of noncustodial parents and the state laws of guardianship and statewardship make the mix of legal considerations even more difficult. Staff of all residential facilities nationwide must be well versed in their respective state's abuse and neglect reporting laws, because they are all likely"mandated reporters." The issue of whether a particular residential facility accepts public funds also may alter certain legal mandates under which the facilities must operate. Overall, the purpose of this article was to acquaint the reader with relevant legal concepts involved in opening, operating, and maintaining a specialized residential facility for children.

Adolescent↗
PubMed1992

A comparison of the cost-effectiveness of day treatment and residential treatment for children with severe behaviour problems.

This study compares the cost of treating 23 children admitted to a residential treatment unit in a psychiatric hospital and 23 children admitted to the same unit after it was converted to a day treatment program, through a retrospective chart review. The two groups were similar in age, gender, diagnosis, severity of pathology, family functioning and support, the number of subjects who dropped-out, and treatment outcome. The average length of stay on the unit dropped from 19.6 to 6.1 months, and the average cost of treatment per child decreased from $61,412 to $9,213 (Canadian dollars, adjusted for inflation). The sharp decrease in treatment time with day treatment may be the result of close links with community schools and maintaining the child in the family and community. The cost savings can be attributed to the shorter hospital stays and the lower operating costs of day treatment. Implications of these findings will be discussed with respect to health care policy including the need to raise awareness of day treatment as a cost-effective alternative to residential hospital treatment.

Adolescent↗
PubMed1992

Mental health status and community adjustment after treatment in a residential treatment program for homeless veterans.

OBJECTIVE: An uncontrolled outcome study was conducted to examine clinical improvement and the relationship of psychiatric and substance abuse problems, community adjustment, and housing status among homeless veterans who participated in a multisite residential treatment program. METHOD: The study was performed at three U.S. Department of Veterans Affairs medical centers in Florida, Ohio, and California. Baseline, discharge, and 3-month postdischarge follow-up data were collected for 255 veterans admitted to the Domiciliary Care for Homeless Veterans Program. Multiple dimensions of outcome were examined, including psychiatric symptoms, alcohol abuse, drug abuse, social contacts, income, employment, and housing. RESULTS: Program participation was found to be associated with improvement in all areas of mental health and community adjustment. Improvement in psychiatric symptoms was associated with superior housing outcomes and improvement in community adjustment. When correlates of improvement in alcohol and drug abuse were examined, only one of eight possible relationships was found to be significant: improvement in alcohol problems was positively associated with improvement in employment. CONCLUSIONS: Homeless mentally ill veterans derive clear benefits from participation in a multidimensional residential treatment program. Improvement in mental health problems, however, is weakly linked to improvement in other areas, suggesting that treatment programs may have to attend separately to multiple domains of life adjustment.

Adult↗
PubMedDate not supplied

Changes in self-perceptions of illicit drug abusers related to time in treatment in two residential treatment programs.

This research investigated the effects of two residential drug treatment programs on changing the self-perceptions of the residents over a 10-month time period. The semantic differential evaluative and potency scales of the concepts Who I Am and Who I Would Like to Be were administered to the residents of these programs on several occasions during the time they were in these programs. The results of this research showed that the residents evaluated Who I Am higher, the longer they remained in these programs.

Adult↗
PubMed2005

Outcome predictors for severe obsessive-compulsive patients in intensive residential treatment.

Intensive residential treatment (IRT) is an effective management approach for those with severe obsessive-compulsive disorder (OCD). This study aimed to identify IRT response predictors for clinical and research use. Consecutive subjects admitted to the Massachusetts General Hospital/McLean OCD Institute (OCDI) between February 1997 and June 2003 were included (N=476). IRT responder and non-responder group characteristics were compared using t-tests and chi(2) analyses. Multiple regression analysis modeled relationships between final OCD severity (Yale-Brown Obsessive-Compulsive scale scores) and predictor variables, while accounting for multicollinearity and potential outliers. Treatment responders comprised 59.3% of the treatment sample. Responders had significantly fewer males (p=0.02), lower depression severity (p=0.03), poorer psychosocial functioning (p=0.03) and fewer tic disorders (0.04), but were not different with respect to admission length, age, marital or employment status, OCD onset, family OCD history, treatment or admission history. In the final regression model, decreased initial OCD severity (p<0.001), female gender (p=0.003) and better initial psychosocial functioning (Work and Social Adjustment scale scores) (p=0.003) were predictors of less severe OCD at discharge (adjusted R-square=0.28). Depression severity (Beck Depression Inventory scores) and insight were not predictive of treatment outcome. Future research is necessary to elucidate putative relationships between gender and OCD psychopathology, and to understand the interplay of psychosocial factors, OCD severity and treatment outcome.

Adolescent↗
PubMed1987

Changes in treatment-related concepts of illicit drug abusers related to time in treatment in two residential treatment programs.

This research investigated the effects of two residential drug treatment programs on changing the attitudes the residents had toward three treatment-related concepts over a 10-month time period. The semantic differential evaluative and potency scales of the concepts Therapeutic Community, Counselor, and Group Therapy were administered to the residents of these programs after they were residents for set periods of time. The results of this research showed that the residents rated the evaluative and potency scales of Group Therapy and Counselor higher the longer they remained in the program.

Adult↗
PubMed2004

Chaplain contacts improve treatment outcomes in residential treatment programs for delinquent adolescents.

This is a report of a study of 828 delinquent adolescents who completed behavioral treatment during 1995, 1996, 1997 in Holy Cross Children's Services programs. The research focused on a measure of chaplain contact time with each youth, and three outcome variables: "planned release" (program completion), living situation at 12 months after discharge, and a calculated cost of care for the 12 month graduates. The findings include statistically significant correlations between chaplain time and all three preferred outcome measures. The results were significant when age, number of prior incarcerations and religiosity variables were controlled for in a regression analysis. When the costs of aftercare for the graduates were computed, the average cost-of care-per-day of the no-Chaplain-contact graduates was significantly higher than that of the high-contact group. Based on the findings, the author suggests that chaplain involvement in the behavioral treatment of delinquent adolescents improves outcomes and is cost effective.

Adolescent↗
PubMed2003

Aftercare attendance and post-treatment functioning of severely substance dependent residential treatment clients.

The present study evaluated the impact of a structured aftercare programme following residential treatment for severe alcohol and/or heroin dependent clients. Over 17 months, 77 participants were recruited to the study and allocated randomly to either a structured aftercare (SA) programme or to unstructured aftercare (UA) of crisis counselling on request. Independent clinicians interviewed participants and collaterals, at 4-month (median) intervals, for 12 months following residential treatment. SA compared to UA was associated with a fourfold increase in aftercare attendance and one-third the rate of uncontrolled principal substance use at follow-up. Participants who attended either type of aftercare relapsed a median of 134 days later than those who attended no aftercare. Overall, 23% of monitored participants remained abstinent throughout, 21% maintained controlled substance use and 56% relapsed, within a median of 36 days following residential treatment. The only significant predictor of days to relapse, controlling for age, was pretreatment use of additional substances. Participants with pretreatment additional substance use relapsed a median of 192 days earlier than those who had used no other substances. The degree of agreement between participant self-reports and collateral reports was fair-to-moderate and moderate among collaterals. Intention-to-treat analyses revealed significant and clinically meaningful reductions in substance use in this sample of severely dependent residential treatment clients. The generalizability of these results is limited because of significant differences in age and presenting substance between the study sample and other clients admitted to the service during the study. This latter group of younger, male, heroin-dependent clients with polydrug use who refuse opioid pharmacotherapy, are more likely to drop out of treatment or relapse early following treatment and continue to present a challenge to treatment services.

Adult↗
PubMed1990

Unit-based clinical and organizational indicators for residential treatment.

A psychiatric residential treatment center has developed a system for monitoring and evaluating the quality of care provided. Administrators of the nine residential treatment units of the Devereux Foundation's Edward L. French Center use a standard form to report on a number of uniform clinical and organizational indicators. The data are evaluated monthly by the utilization review committee, quarterly by the quality assurance committee, and semiannually and annually by other administrators, committees, and the foundation's board of trustees. This process has been an effective mechanism for identifying trends and patterns in client care, for improving client care, and for providing clues to relationships among organizational problems.

Hospitals, Private↗
PubMed2000

Michael--psychotherapeutic treatment in the context of residential treatment.

This paper describes the five-year psychotherapy of a boy suffering from a very early developmental disorder. The treatment involved bringing the child back to the point of crisis in maternal caring. This type of regression is vital in treating certain severe disturbances, but it can also be dangerous; hence the importance of an appropriate environmental space. The treatment milieu has to be both a "holding" environment and a "containing" one, for child and therapist alike. Residential treatment based on a continuity of transitional spaces provided such an environment for Michael and helped nurture his emotional growth.

Child↗