Assessing teaching opportunities in a residential treatment facility

Seventeen living units in a residential treatment facility for developmentally disabled persons were assessed to determine the availability of teaching opportunities during the course of a normal day's routine. Teaching opportunities exist when the environment is arranged so that residents can participate in the ongoing activities. The teaching opportunities are identified within components that are recognizable activities that occur routinely and have a functional purpose. An assessment form was constructed as a means for documenting teachng opportunities. Assessments were conducted continuously from early morning through evening activities. The results of the assessments suggested that two approaches to resident care were in operation at the facility: one was characterized by a traditional care/custodial model, the other was characterized by a teaching model. On units where the number of teaching opportunities available was high, there was a smaller percentage of unstructured time, i.e., blocks of time when opportunities to engage in structured activities were not available to the residents.     

Therapeutic group approaches in an inpatient facility for children and adolescents: A 15-year perspective

Inner city, psychiatrically hospitalized adolescents are accessible to group therapy intervention. We developed a unique approach combining Slavson's theories with principles of family treatment and psychoanalytic theory. The group was conceptualized as a corrective family experience with the therapists functioning as model parents. Our model relies on a four-phase process, which is discussed.     

Increasing volunteering at a residential facility: An experimental evaluation of a volunteer assistance program

A helpful component for comprehensive residential services for developmentally disabled persons is volunteer assistance. This investigation involved the evaluation of a program developed to increase the amount of volunteer assistance provided to a public residential facility. The program consisted of three types of related procedures: systematic volunteer recruitment steps, specific volunteer activities at the facility, and consequence/recognition for the volunteer assistance. The program was successively implemented to involve students as volunteers from two local universities, and resulted in an increase in new students volunteering from both universities. Additionally, the frequency with which the students volunteered at the residential facility increased substantially from both universities relative to control periods during which the volunteer program was not in effect. Results are discussed in terms of the benefits of volunteers and continued research to increase involvement of other prospective groups of volunteers.     

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.     

Multiple family therapy in a residential setting for adolescents*

Treating severely disturbed adolescents in a residential setting without including the family seems impossible. Several ways of letting the family participate in the clinical treatment are discussed. The focus of this article lies in multiple family therapy: groups of family members, adolescents and staff are treating each other. The objects of these meetings are manifold: to modify the stereotyped views that all the participants have of each other, to reduce the isolation of the family which is created by their child's admission, to stimulate interaction and mutual correction between family members, adolescents and staff, and to create a warm-up for and understanding of family system therapy. These multiple family sessions, which take place in a clinic with sixty disturbed adolescents, have a strong influence on the entire therapeutic process. Their impact is felt in the group psychotherapy, psychodrama and other forms of therapy.     

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.     

Evaluation of a residential treatment center for emotionally disturbed adolescents

This study examines a residential treatment center for emotionally disturbed female adolescents by comparing changes in personality as measured by objective tests given while in residence and by a questionnaire sent to former residents at least six months after release. Two hypotheses were tested. The first was that the girls would be successful when they returned to their communities. "Success" was defined by a number of variables on a questionnaire. Responses to the questions indicate that the girls are doing well. The second hypothesis was that the girls would show significant improvement in their scores on two personality tests taken at the time they were admitted and at the time of their release. A comparison of the mean scores of the various factors on each test showed significant improvement.     

Electronic language: A study of word processing by emotionally disturbed children and adolescents in residential treatment

The word-processing language use of a small group of severely emotionally disturbed children and adolescents was compared with their handwritten productions. A content analysis based on a total sample of 4,112 words was performed to explore the thematic and structrual language differences between the two writing modes. The findings indicate that the computer-mediated writing tended to improve some aspects of thematic expression, while the handwritten mode was preferable for certain structural characteristics.     

Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility

A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.     

Helping adolescents in crisis: a case study

Suicide among adolescents is a major mental health problem in the United States. The most recent data on adolescent suicide indicate that approximately 5,170 of those between the ages of 15 and 20 took their lives. Several researchers asserted that in most cases something could have been done to prevent the actual suicide. The author developed five stages (suicidal signs, establishing rapport, making referral, constructive actions, and self-management) that may be used to help adolescents in distress. The five stages were used in a case study to demonstrate the roles played by teacher, friend, and parents in helping an adolescent through a crisis.     

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.     

Discriminating personality disorders using the WAIS-R: a comparison of three approaches

The purpose of this article is to determine if performance on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) can be used to discriminate between the different taxonomies of personality disorder classification specified by three models: the biosocial, the interpersonal, and that described by the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987). Three discriminant function analyses were performed and the results indicated the usefulness of the WAIS-R in making such differentiations for all the approaches. The WAIS-R proved most effective with the biosocial model, evidencing a robust and clinically meaningful pattern of results. Implications for further research are discussed.     

Behavioral skills training to increase interview skills of adolescent males in a juvenile residential treatment facility

Some studies suggest that acquiring employment following release from prison may reduce recidivism; however, few studies have evaluated procedures for teaching job-related skills to adolescents in residential detention facilities. Stocco et al. (2017) used behavioral skills training (BST) to improve interview skills of college students. The current study used a nonconcurrent multiple baseline design across participants to evaluate the extent to which BST improved interview skills for 7 adolescents who had been adjudicated for sexual offenses. Results show that BST increased appropriate responses to interview questions for 4 students and BST plus modifications (i.e., stimulus and response prompts) increased correct responding to questions for the other 3. In addition, BST increased appropriate questions, correct posture, and smiling, and decreased fidgeting for all 7 students. We briefly discuss the social implications of teaching interview skills to adjudicated adolescents, as well as the limitations of the findings.     

Identifying health-seeking behaviors: a study of adolescents

While it is known that health-seeking behaviors are influenced by information-seeking behaviors, reported research on adolescents' information-seeking behaviors is minimal. Available definitive information primarily addresses ways in which peers, parents, and health professionals are used as sources of information concerning sexuality. Research is now needed on how adolescents use the media and other sources of health information to effect changes in their lives. The present study sought to determine how adolescents' health-seeking behaviors, which include self-management and information-seeking behaviors, differ according to age, race, socioeconomic status, gender, and religion. The study was based on two assumptions: Self-management and information-seeking behaviors are fundamental to adolescents' health-seeking behaviors, and subjects answer self-management and information-seeking questions in terms of past behaviors and their behavioral intent. Important findings that emerged from this investigation include confirmation of gender as a differentiating variable for the performance of information-seeking behavior and positive health behaviors among black adolescents. Further, subjects reported an overall positive composite of health-seeking behaviors.     

Communicating power and resistance: exploring interactions between aboriginal youth and non-aboriginal staff members in a residential child welfare facility

Aboriginal youth are highly overrepresented within the child welfare system. High-risk youth are often placed in out-of-community residential placements. Such residential placements have been described by some as a continuation of colonial practices. Using communication theory as a conceptual model, we propose a qualitative analysis of micro-interactions that take place between Aboriginal youth and non-Aboriginal workers during the management of high-risk behaviors within a residential program. Three broad categories of interaction emerge from the data: complementary, symmetrical/complementary (where youth show a form of submission despite resistance), and symmetrical (characterized by a power struggle). Despite the diversity of interactions along this symmetrical to complementary continuum, interventions always start and finish in the same fashion. Moreover, the nature of interactions depended mostly on how quickly youth accepted the consequences of their behaviors. We also extracted five categories related to culture, race or context that are perceived as influencing the interactions that take place between staff and youth. The analysis of micro-interactions within clinical, organizational, social and historical contexts points to mechanisms by which asymmetrical power relations may be replicated on a day-to-day basis despite the best intentions of residential workers.