Characteristics of Children and Adolescents Admitted to a Residential Treatment Center (original) (raw)
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American Journal of Orthopsychiatry, 2012
This study examined the relationship between gender, abuse history, and clinical change in a residential treatment program for youth with emotional and behavioral disturbance. Admission data and data collected after 1 year of treatment or at discharge were examined for 1,303 youth. Measures included the Suicide Probability Scale, Child Behavior Checklist, and the Diagnostic Interview Schedule for Children. Data also included medication count, demographic data, and history of sexual or physical abuse or both. At intake, girls scored significantly more pathologically than boys on 9 out of 12 measures. At intake, abused youth indicated more hostility, anxiety, and mood disorder symptoms as well as psychotropic medication usage than nonabused youth. Youth improved significantly on all outcome measures with treatment, although interaction effects indicate some differing treatment responses by abuse history or gender. After treatment, girls still scored significantly higher than boys on 6 of 8 outcome measures, and abused youth, especially youth experiencing both sexual and physical abuse, had significantly higher anxiety, affective, behavior, and eating disorder symptom counts and were on more psychotropic medications than nonabused youth. Although behaviorally focused treatment was associated with improvement on every measure, the most important implication of our study is that a singular treatment approach does not fit all youth completely as reflected by continuing treatment needs in our most troubled youth. Additional symptom-focused treatment and research attention must be given to girls and abused youth in residential care to maximize their therapeutic outcomes.
IS LONG-TERM RESIDENTIAL TREATMENT EFFECTIVE FOR ADOLESCENTS? A TREATMENT OUTCOME STUDY
There is a lack of research concerning the effectiveness of residential treatment for troubled adolescents. Due to a focus on internal controls in this area of research, there has been no conclusion as to how helpful such treatment is for real world clients. This is an effectiveness study that serves as a preliminary outcome evaluation for the Academy at Swift River, an emotional growth boarding school in Cummington, Massachusetts. Both the program graduates and their parents completed detailed questionnaires concerning the perceived behavior and attitude change of the patient. They were also given a standardized test by which the students could be compared to a national norm on the dimensions of clinical pathology and positive adaptation. Results found that the majority of pathological and adaptive behaviors were perceived to have improved by both the students and parents, but that the standardized measures of parent relations, selfreliance, conduct, and self-reported depression were still well within the clinical range. Despite these shortcomings, 100% of patients and their parents said that they would recommend treatment at ASR to others. Though much more research needs to be done in this field, this study lends support to the idea that residential treatment can be very effective for troubled adolescents.
Children and Youth Services Review, 2013
Over the past decade, the level of clinical needs of youth in residential treatment has increased significantly. Youth in out-of-home settings typically experience higher levels of psychotropic medication use than their peers living at home, even when controlling for the severity of clinical issues. The purpose of the current study was to examine the effects of an approach to clinically reassess psychotropic medication utilization for youth residing in residential treatment settings while also observing the impact on the youth's need for physical containment. Medication changes were based on a data-informed process, using input from a multidisciplinary treatment team. Data for 531 youth who were consecutively admitted to one of two non-affiliated intensive residential treatment programs, one in the Midwest and one in New England, was analyzed. Over half of these youth (n = 292, 55%) had their medications reduced during their stay and only 14% (n = 76) were prescribed more medication at discharge than they had been taking at admission. The remainder either saw no change during their stay (n = 104, 20%) or were never on medication at any time (n = 59, 11%). From admission to discharge there was a 62% decrease in the number of assaultive incidents as well as a 72% decrease in the use of physical restraints. These results support the view that residential treatment can provide a treatment milieu that allows for thoughtful reassessment of the clinical basis for behavioral disorders in children that can achieve the dual goals of medication reduction and behavioral stabilization.
Residential Treatment for Children & Youth, 2019
Although research has repeatedly shown that residential care for youth with a serious behavior problem has little rehabilitation success, there is a group of youth for whom residential care in a locked setting is necessary. In this article, a manualized therapeutic residential treatment model for adolescents with serious behavior problems, MultifunC, is evaluated. The program theory of MultifunC is based on a review of the literature and synthesis effective treatment components. This study included 80 youth aged 15-17 years with a medium high or high risk for reoffending. Half of the participants received MultifunC, and half treatment as usual (TAU). Although non-randomized, the two groups were found to be equivalent on important background variables. After 24 months, this first evaluation of MultifunC demonstrated that youth participating in MultifunC had a reduced need for residential care in a locked setting as well as out-of-home placement in general compared to youth in the TAU group. The economic analysis found MultifunC to be a cost-effective alternative to TAU due to the reduced need of residential care in locked settings. There were no significant effects on reoffending or psychiatric care.
The Trajectory of Change for Children and Youth in Residential Treatment
Child Psychiatry & Human Development, 2010
This study examined the symptom response trajectories for 225 children and youth throughout a period of residential treatment. With the 10-item Conners' Global Index (CGI) as the primary outcome measure, assessments were completed on a biweekly basis during the average 4 month stay within the youth's residential treatment. Clients demonstrated an ongoing reduction of symptoms, and the severity of baseline symptoms influenced the trajectory of the symptom reduction. In addition, symptom reduction was characterized as logarithmic, particularly when controlling for the baseline severity of symptoms. Implications of these findings for administrators, practitioners, and researchers of residential treatment are discussed. Keywords Child Á Youth Á Treatment Á Mental health Á Longitudinal Á Trajectory Residential treatment is among the most expensive components of the mental health system for children and youth [1], and although several large scale reviews indicate that a period of residential treatment can improve functioning for children and youth that have serious behavioural and emotional disorders [2-4], uncertainty remains regarding the trajectory through which symptom change occurs within these settings [5]. In particular, the length of stay in treatment appears to be a particularly contentious issue, with duration of residential programs ranging from a few months [6], to a few years [5]. There is, however, a noteworthy lack of concern within the literature, regarding the point at which
Residential Treatment For Children & Youth, 2013
We investigated the effectiveness treatment for substance abusing youth at an innovative residential program in Canada, the Pine River Institute. We explored: (a) whether pre-treatment problems were predicted by individual differences; (b) what predicted treatment progression; (c) the amount of improvement pre-to post-treatment; and (d) what predicted those improvements. From data from 148 youths, we found that: (a) parental divorce and mental health issues were associated with pre-treatment problems; (b) youths who attended PRI in more recent years progressed further through treatment; (c) improvements were significant and large; and (d) youths who progress further in treatment experience greater improvements.