Differences in risk factors and adjustment for male and female delinquents in treatment foster care

Differences by gender in the presence of risk factors, patterns of previous delinquency, and response to treatment were examined for a sample of 88 adolescents who were placed in Treatment Foster Care. Females were found to have fewer foster parent-reported problem behaviors than their male counterparts during the first month of treatment. By month 6, problem behavior levels for males had dropped, while scores for female subjects had increased to the level of males at month 1. No differences in pre-post arrest data or program completion rates for males and females were found. Implications for research on and treatment of female adolescents with conduct problems are discussed.     

Maintaining placement for troubled and disruptive adolescents in voluntary residential care: The role of reduced youth-to-staff ratio

We evaluated a program to protect the placements of 23 highly troublesome youth in voluntary residential care by reducing youth-to-staff ratios. Specifically, the youth were moved from regular program homes (with eight youth) to reduced ratio homes (with only four youth) instead of being terminated from the program. We provide evidence supporting the assertion that youth in the study sample were highly troublesome and at high risk for program failure and more restrictive placements. Placement in the reduced ratio homes protected the trouble youths' placement, resulting in an additional mean length of stay of 950 day without an increase in program restrictiveness. Further, the reduced ratio homes increased the chances of success in the program for the study sample to a level equivalent to that for the much less troubled comparison sample. Cost estimates are also provided.     

Mathematical modeling of movement between residential placements: A systems analytic approach to understanding systems of care

Although the concept of a system of care for children and adolescents with a severe emotional disturbance has become core to treatment philosophy, very little research has focused on systems of care as systems. This article attempts to contribute to the development of a systems research paradigm in children's mental health as well as to add to the substantive knowledge of utilization of and movement between residential options in a statewide multiagency service delivery system. Information on residential placement gathered at six month intervals over a three year period is used to develop a mathematical model of the system of care. This model can help administrators to predict future needs for residential care, and to project probable outcomes of alternative strategies for meeting the needs of these children and adolescents.     

Availability to peer group treatment in residential care as a function of relational ethics

Forty-five adolescent boys from abusive and depriving homes were not doing well in positive peer culture residential care. Despite their backgrounds, given a modified form of the Relational Ethics Scale, they indicated that their relational life with their families of origin was trustworthy, fair, and worthy of continued devotion. In contrast, on the Firo-B these same boys demonstrated distrust of others outside of their families and an unwillingness to get involved. These results support the inference from contextual family theory that peer group interventions cannot bypass identification and resolution of the injustices that took place in the family of origin.This project was fully supported by Teen Ranch, Inc., Marlette, MI 48453.     

Layers of engagement: Staff perceptions of spiritual care in residential aged care

ABSTRACT

Addressing the spiritual care needs of residents living in aged-care facilities should be an important dimension of quality care. We conducted semi-structured interviews with residential aged-care staff (including caregivers, nurses, managers, and chaplains) in New Zealand to explore how spiritual care is understood and operationalized. Many participants appeared to equate spiritual care with holistic care that respects the whole person. Participants discussed five types of spiritual care engagement requiring different skills, knowledge, and personal commitment, including information gathering, facilitation, companionship, end-of-life care, and counseling. Our findings suggest that the spiritual care that was offered by our participants, clergy and non-clergy alike, was predominantly informal and unplanned.     

The nature of quality of life in residential care facilities: the case of White older South Africans

This study describes the nature of quality of life (QoL) from the perspective of older South Africans (n?=?41) in residential care facilities (female =?75%; age range 62–95 years). The residents participated in individual in-depth interviews and focus groups. They also set down their narrative reflections on their QoL in journals. Data were analysed by means of interpretative phenomenological analysis. Findings reveal the resident older South Africans regard QoL as a spiritually informed worldview of life events, coping with challenges and being mindful of others. The residents perceived QoL to include proximity and quality and reciprocity with others. QoL among older people is context and people specific.     

Development and dissemination of collaborative family-oriented services: the case of community/day residential care in Israel

The initiation, development, and dissemination of family-oriented programs are a unifying thread that highlights family therapy's contribution to the fields of mental/physical health and social services. These demanding tasks require an ecosystemic vision, a supportive larger context, and a range of skills. This article delineates the evolution of community and day residential care in Israel by examining processes at different ecological levels: the formulation and implementation of national social policy, the follow-up of two family-oriented facilities, one of which thrived while the other eventually closed, and the residential care provided to 1 family with 3 children. The analysis of this multilevel data highlights 4 facilitating/obstructing factors that have had major impact on family-oriented programs: support by both national and local sociopolitical-professional administration, program's management autonomy, staff training, support and development, and effective facility leadership that establishes and nurtures family-oriented organizational structure and culture.     

Different Pathways to Juvenile Delinquency: Characteristics of Early and Late Starters in a Sample of Previously Incarcerated Youth

We examined the differences between early and late start juvenile delinquents in a sample of 531 previously incarcerated youth in Oregon's juvenile justice system. Data were analyzed with logistic regression to predict early start delinquency based on four explanatory variables: foster care experience, family criminality, special education disability, and socioeconomic status. Youth with foster care experience were four times more likely to be early start delinquents than youth with no foster care experience. Youth with a family member convicted of a felony were two times more likely to be early start delinquents than youth with no family felony. Implications for future research are discussed, as well as implications for practice and policy. We suggest that future studies examine differences between male and female delinquents, the effects of foster care on children, and interfamilial processes that facilitate criminal behavior. Efforts to support children and families at risk of abuse and neglect should be reexamined in light of the results of our study, which adds to the emerging knowledge base regarding the relationships between violence experienced in early childhood, and future criminal behavior.     

Treating Anti-social Behavior in Adolescents: A Comparison of Multi-modal and Psychodynamic Oriented Group Interventions

This study compared the efficacy of a multimodal intervention (MMI) and a psychodynamic oriented group intervention (POGI) on antisocial behavior among Nigerian adolescents. A pretest-posttest design was used. Forty-one adolescents drawn from the streets of a Nigerian city (N =20), and a state child correction facility (N=21) participated in the study. The children were randomly assigned to a MMI, POGI and waiting list control (WLC) groups. Ages ranged from 10 to 18 years (mean =14.5; SD=2.1). Data collected were analyzed using multiple group comparison procedures. Results showed that MMI significantly reduced self-reported antisocial behavior of the adolescents as compared to WLC and POGI, respectively. A multimodal intervention approach appears to be more effective in treating antisocial behavior in adolescents than a psychodynamic oriented group intervention.     

Female Juvenile Offending: A Review of Characteristics and Contexts

We reviewed current literature on female juvenile offending including the scope and nature of offending by female adolescents and the risk and protective factors across ecological contexts. We suggested that female juvenile offending is best viewed within a multidimensional framework in which female adolescent developmental characteristics as well as the ecological contexts must be considered for effective preventions and interventions. An ecological framework may assist professionals to target adolescent female offenders who are most likely to be chronic offenders. We offered both an intervention and research frame for addressing the issue of offending among our female youth and concluded that, as the incidence of female juvenile offending increases, researchers and practitioners are well advised to consider both the contexts surrounding the potential female adolescent offender as well as the contexts that contribute to her resiliency against offending.     

Self-help for binge eating disorder in primary care: A randomized controlled trial with ethnically and racially diverse obese patients

Objective

The objective was to examine the effectiveness of a self-help treatment as a first line primary care intervention for binge eating disorder (BED) in obese patients. This study compared the effectiveness of a usual care plus self-help version of cognitive behavioral therapy (shCBT) to usual care (UC) only in ethnically/racially diverse obese patients with BED in primary care settings in an urban center.

Method

48 obese patients with BED were randomly assigned to either shCBT (N = 24) or UC (N = 24) for four months. Independent assessments were performed monthly throughout treatment and at post-treatment.

Results

Binge-eating remission rates did not differ significantly between shCBT (25%) and UC (8.3%) at post-treatment. Mixed models of binge eating frequency determined using the Eating Disorder Examination (EDE) revealed significant decreases for both conditions but that shCBT and UC did not differ. Mixed models of binge eating frequency from repeated monthly EDE-questionnaire assessments revealed a significant treatment-by-time interaction indicating that shCBT had significant reductions whereas UC did not during the four-month treatments. Mixed models revealed no differences between groups on associated eating disorder psychopathology or depression. No weight loss was observed in either condition.

Conclusions

Our findings suggest that pure self-help CBT did not show effectiveness relative to usual care for treating BED in obese patients in primary care. Thus, self-help CBT may not have utility as a front-line intervention for BED for obese patients in primary care and future studies should test guided-self-help methods for delivering CBT in primary care generalist settings.     

Children's perceptions and experiences of care giving: A focus group study

The stress of care giving for spouses and adult children has been extensively documented in the empirical literature. More recently attention has been paid to children's involvement in family care giving. Qualitative studies in the social welfare field have highlighted the social restrictions caring places upon children. There remains a need, however, to understand what children are thinking and feeling in an effort to cope with their care-giving demands. This study used a focus group methodology and individual interviews to explore the experiences of 17 young carers aged between 10 and 16. Thematic analysis was employed to identify themes relating to the nature of stressors, their appraisal of them, and the coping strategies they use to manage the task of caring.     

A critical comparison of two random-walk models for two-choice reaction time

Two random-walk models for two-choice reaction time, being the sequential probability ratio test model initially suggested by Stone and the relative judgment theory recently proposed by Link, are here compared. The comparison shows the precise mathematical relation between the models, the predictions they have in common, and two points at which they differ. Three experiments concerned with the effect of stimulus probability on two-choice reaction time are examined with respect to three predictions from the models. In this three-way comparison the two models are more like each other than either is to the data; a greater variety of phenomena is revealed than either model can at present accommodate.     

A comparison of two psychological treatments for bulimia nervosa: Implications for models of maintenance

In an effort to elucidate the role of cognitive factors in the maintenance of bulimia nervosa, the efficacy of two psychological treatments was examined in a randomised control trial: cognitive behaviour therapy in the absence of explicit exposure instructions was compared with exposure and response prevention treatment in the absence of cognitive restructuring procedures. In the short term both treatments were successful at effecting substantial improvement in both the specific and the non-specific psychopathology of the disorder. However, at a one year follow up, whilst improvements were well maintained for those who had received the cognitive-behavioural treatment, virtually all of those who had responded to the purely behavioural treatment had relapsed. This provides some support for the cognitive model of the maintenance of bulimia nervosa. Nevertheless, the two treatment groups could not be distinguished on post-treatment measures of cognitive disturbance and neither was it the case that residual levels of cognitive disturbance, as assessed, predicted relapse. This may suggest that the level at which the necessary cognitive change takes place may not be accessible by conventional assessment procedures.     

Aggressive adolescents in residential care: a selective review of treatment requirements and models

This article presents a selective inventory of treatment methods of aggressive behavior. Special attention is paid to types of intervention that, according to research, are frequently used in Dutch residential youth care. These methods are based on (1) principles of (cognitive) behavior management and control, (2) the social competence model, and (3) influencing the peer culture. Suggestions are made as to how the treatment of aggressive adolescents may be realized in residential settings. The article concludes that more attention should be paid to the involvement of parents and to the part played by the peer group in the treatment of aggressive behavior.     

The functions and value of reminiscence for older adults in long-term residential care facilities

For the many older adults living in long-term care facilities, the ability to connect with others, as well as with one’s own personal past, may be of particular value. Reflecting on the past and sharing reminiscences with others serves different psychosocial functions in various settings. This study examined the functions of reminiscence for long-term care residents in the United States (M_age?=?86.5) by addressing the self-reported frequency of reminiscence, the counterparties involved, the overall purpose and value of reminiscence, and the relation to residents’ mental health and well-being. Results demonstrated that although some functions of reminiscence were comparable to those found in community-dwelling older adults, others were unique to the long-term care setting. Residents were most likely to reminisce alone and they found the experience enjoyable. They reported engaging in and enjoying reminiscence with family more than with fellow residents, and a subset desired increased opportunities to share memories with healthcare providers. Residents with lower morale and more depressive symptoms were more likely to engage in unhealthy styles of reminiscence. These findings suggest that interventions shaping reminiscence encounters may have positive outcomes for long-term care residents.     

Using positive peer reporting to improve the social interactions and acceptance of socially isolated adolescents in residential care: a systematic replication

We studied how rewarding youth in residential care for publicly reporting positive social behavior influenced the social interactions and acceptance of their most socially isolated peers. Results showed that the intervention resulted in substantial improvements in social interactions by the previously isolated peers. Peer acceptance ratings also improved for 2 of the target youths.