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The multisystemic therapy (MST) treatment model is derived from social ecological theory, through which known risk and protective factors of ecological systems are identified by indirect and direct contribution to at-risk behaviors. However, youth with emotional disturbances postdischarge from residential treatment facilities are often referred to MST due to managed care organizations extending beyond the once identified population of juvenile offenders. Consequently, MST works within the ecological system at which an integration of MST and expressive techniques (ETs) can occur in order to simultaneously work within the individual system. In this article, we discuss the foundation of MST and present a retrospective case analysis of the integration of MST and ETs. We discuss limitations and future research considerations. [ABSTRACT FROM AUTHOR]

Although the notion of involving families in residential treatment is not new, relatively little research has specifically examined youth perceptions of improvement in family functioning as an outcome of adolescent residential treatment. This study investigated youth perceptions of family functioning (as measured by the Family Adaptability and Cohesion Evaluation Scales-III and indicated via the Circumplex Model) at admission and after at least 5 months of treatment. Posttest results specify significant perceptual improvement with families that indicated functional challenges per the Circumplex Model, and family functioning was maintained for youth (baseline) perceiving of their families as healthy. [ABSTRACT FROM AUTHOR]

Objective: We examined outcomes from a residential treatment program emphasizing exposure and response prevention (ERP) to determine if the typically robust response to this treatment in outpatient settings extends to patients treated in this unique context.Method: One hundred and seventy-two adolescents with primary Obsessive-compulsive disorder (OCD) completed measures at admission and discharge. Almost all (92.4%) participants had at least two diagnoses and nearly half (44.2%) had three or more. Treatment consisted of intensive ERP (i.e., approximately 26.5 hr per week), additional cognitive behavioral therapy interventions, and medication management within a residential setting. In contrast to the samples reported on in the vast majority of other pediatric OCD trials, participants in the current study were living apart from their families and were immersed within the treatment setting, with staff members available at all times.Results: Paired samplet-tests revealed significant decreases in OCD and depression severity.Conclusions: Results suggest that residential treatment for adolescents with OCD using a multimodal approach emphasizing ERP can be effective for complex cases with significant comorbidity. Results were comparable with several randomized controlled trials. [ABSTRACT FROM PUBLISHER]

This study examined parental predictors of alcohol use and alcohol-related consequences among 9th-grade students ( N = 296). Parental disapproval of teen drinking and quality of parent-child general communication were significant predictors of drinking behaviors. Implications for counselors are discussed. [ABSTRACT FROM AUTHOR]

In substance abuse treatment, general self-efficacy and religiousness are factors that may support positive outcomes. The authors surveyed clients receiving substance abuse treatment ( N = 121) and found that religious coping predicted general self-efficacy scores. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this research was to better understand the substance use and sexual risk taking behavior among high-risk adolescent populations placed in residential treatment facilities, including those in the foster care and juvenile justice systems. The primary predictors considered in this study included caregiver support, caregiver closeness, other adult support, adolescent self-disclosure/communication with caregiver, caregiver expectations about sexual behavior, and peer influence regards to drugs/alcohol and sexual behavior. Participants included 120 adolescent females in grades 7 to 12 (median grade = 10; mean age 15.7 years), primarily African American (57.2 %) and White (29 %), in a residential treatment setting in a large urban area in the Midwest. Caregiver support and self-disclosure/communication with caregivers predicted condom use at most recent intercourse, but variables related to substance use were most consistently predictive of sexuality variables including onset and frequency of behavior. None of these support variables significantly predicted onset and frequency of substance use. Caregiver support was the contributing variable in predicting academic achievement. [ABSTRACT FROM AUTHOR]

This is the eleventh in a series of papers issued by the Association of Children’s Residential Centers (ACRC) regarding key issues faced by the field in response to emerging research, policy, and best practice. This paper builds on the previous papers in the Redefining Residential Series to address psychotropic medication use in residential treatment. Evidence for use of psychotropic medication with children and youth and the complications presented by youth typically served in residential centers are reviewed. Several critical practices residential programs should consider implementing are identified. Barriers to successful implementation are examined. A call is made for increased emphasis on what is described as rational use of psychotropic medications, prescribed in conjunction with other treatment modalities and careful monitoring of progress and outcomes. [ABSTRACT FROM PUBLISHER]

Background: An increasing number of young people have made contact with the Child and Adolescent Mental Health Services (CAMHS). However, only a small proportion of the population with emotional problems, actually seek specialized care. Research concerning the help-seeking process and pathways to care of a clinical sample could help to develop effective health policies to facilitate access to specialized care. Aim: To analyze the access pattern for CAMHS, reasons of contact and care pathways of a consecutive sample of first-time patients. Our aim was to analyze the association between source of referral, socio-demographic and clinical variables. Methods: Standardized assessment instruments and information concerning access patterns and care pathways were collected from 399 patients at first-time contact with CAMHS in a Northern Italian Region. Results: Most patients were referred to CAMHS by school teachers (36 %) or health professionals (32 %), while only 17 % of the parents sought help by themselves. School issues (50 %) and emotional problems (17 %) were the most frequent reasons for contact. The proportion of first-time contacts with no diagnosis of mental disorder at their first consultation did not differ by source of referral. Parents of children who did not receive a clinical diagnosis of mental disorders described them as "psychosocially impaired" and their condition as "clinically severe" likewise parents of patients who received a psychiatric diagnosis. Patients with externalizing problems were more frequently referred by the parents themselves, while youth with internalizing problems were more often referred through health professionals. Families with non-traditional structures (adoptive, foster care, mono-parental) were more likely to consult CAMHS directly, while immigrant youth were more often referred by teachers. Conclusion: Socio-demographic and clinical characteristics can affect pathways to care. To improve early access to care for children and adolescents with ongoing mental disorders, a plan for proper action addressed to teachers and health professionals may well be important. This would improve their ability to recognize emotional and behavioral problems and use proper referral pathways, while informative intervention addressed to non-Italian families should inform them about the functioning and the mission of CAMHS. [ABSTRACT FROM AUTHOR]

Adopted children are disproportionately represented in residential treatment programs in the United States. Adopted children in the United States constitute only 2% to 3% of the U.S population. Nevertheless, they comprise approximately 16.5% of the population in residential care. This descriptive study evaluated a sample of 473 psychological evaluations of adolescents in wilderness and residential treatment centers. Results indicated that, compared with nonadopted youth, adopted youth had greater histories of recent trauma, higher rates of suicidal tendency and biological parents’ mental illness, and poorer academic achievement. However, there were no significant differences between adopted and nonadopted youths in terms of defiant behaviors, IQ, substance use/abuse, reasons for referral, impulsivity, anxiety, or depression. Study results suggest that wilderness and residential programs may need to target programmatic elements specifically to meet the special needs of adopted adolescents who comprise a significant percentage of their client population. [ABSTRACT FROM AUTHOR]

Background Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18–25 years old). Despite benefit shown from emerging adults’ participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts. Methods Emerging adults ( N = 284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, substance use disorder (SUD) medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates. Results Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups). Conclusions Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment. [ABSTRACT FROM AUTHOR]

The study investigated the perceptions that caregivers working at children's homes have regarding their roles/responsibilities. The aim was to obtain insight into their subjective experiences and realities. This qualitative study was guided by the interpretive paradigm and included eleven caregivers. Focus group discussions, group collage and semi-structured interviews served as data collection methods. The caregivers perceived their roles/responsibilities as including the provision of food, shelter and protective environment; also catering to the children's emotional and health requirements. Caregivers viewed their work environment as child-focused and expressed the need to be acknowledged as professionals and to be empowered with more training. [ABSTRACT FROM AUTHOR]

As early as the 1970s, residential care sought to include families in the clinical treatment of their children (Kemp, 1971). However, families have not been consistently included in residential treatment (Sunseri, 2004) and models are needed to clinically support the phases of family treatment. This article describes an integrative clinical phase model for supporting family therapy with an adolescent in a residential program. Several different phase models are reviewed for family involvement in residential treatment (Fairhurst, 1996; Jones, 1985; Martone, Kemp, & Pearson, 1989). A phase model is advanced that includes updates in family-centered work, corresponding treatment techniques, and knowledge gained in supporting families at one residential program, the Wediko School. [ABSTRACT FROM AUTHOR]

Increasing numbers of younger children are entering intensive residential treatment, but most programs were developed for older children. This study compares preadolescent and adolescent children in a residential treatment program across a broad range of behavioral, emotional, and medical measures. This study examined data for 693 children consecutively admitted to a psychiatric residential treatment facility between January 2005 and December 2010. Data included problems at admission, early problem behavior in program, use of seclusion and restraint, health care and psychological services utilization, psychotropic medications, and length of stay. Generally, preadolescents were more behaviorally and emotionally troubled than were adolescents. Adolescents had higher medical care utilization rates. Results highlight the need for designing and implementing treatment programs tailored to meet the differing needs of preadolescent and adolescent children. [ABSTRACT FROM PUBLISHER]

Adolescents in residential care settings have double the national average of suicide risk histories (attempts, threats, and ideation). However, little is known about youth with specific suicide-risk histories. This study explored differences in demographic characteristics and mental health variables for 509 youth in residential care with high and low suicide-risk histories. Overall, nearly 40% of participants had a high suicide-risk history, and significant differences between low and high suicide-risk history groups were found for multiple variables (e.g., gender, ethnicity, number of diagnoses). This study highlights a need for research into areas associated with suicide-risk history in residential care. [ABSTRACT FROM PUBLISHER]

The idea of implementing consistent overall clinical approaches in residential treatment facilities may improve care by influencing family engagement, interactional styles of residential staff and clinicians with children and youth, specific therapeutic interventions including the management of problematic behaviors, milieu approaches, and group interventions, as well as inform programmatic structure, rules, and expectations of residential living. A clinical framework should demonstrate contemporary and evidence supported practices in order to achieve meaningful success. This article summarizes a literature search and discussion points regarding family/community engagement, individualized assessment/treatment, interprofessional teams, and organizational factors in developing a clinical framework for children/youth residential treatment. [ABSTRACT FROM PUBLISHER]

Widespread international concern exists about school dropout and substance use among high risk youth. This article examines the issue in Israel and the impact of a 90 day treatment program on a prospective sample of youth. A cohort of 77 youths completed a self-report questionnaire prior to receiving substance abuse treatment. These youth were compared to those attending and disengaged from school. With the exception of inhalants that tend to be a substance more commonly used by youth in school, dropouts report much higher rates of substance use especially those referred to treatment. For this population, the impact of a 90 day residential treatment program was evaluated. Results show the potential such treatment has on reducing substance use. Given the paucity of literature on this topic, this paper makes an initial contribution to understanding a growing problem of youth who have dropped out of school and who are substance users. [ABSTRACT FROM AUTHOR]

We investigated the effectiveness treatment for substance abusing youth at an innovative residential program in Canada, the Pine River Institute (PRI). We explored (a) whether pretreatment problems were predicted by individual differences; (b) what predicted treatment progression; (c) the amount of improvement pre- to posttreatment; and (d) what predicted those improvements. From data from 148 youths, we found that (a) parental divorce and mental health issues were associated with pretreatment 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. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate agreement and theoretically relevant moderators of agreement between non-parent caregivers and teachers in a sample of traumatized youth. Two hundred eleven children (ages 5–16 years) who had experienced abuse and/or neglect were administered the Trauma Symptom Checklist for Children (TSCC) shortly after their admission. Additionally, their primary non-parent caregivers were administered the Child Behavior Checklist (CBCL) and their teachers were administered the Teacher Report Form (TRF). Inter-rater agreement between caregivers and teachers was low (Total problems, ICC = 0.29). Agreement was higher for Externalizing Problems as compared to Internalizing Problems. Agreement was generally not moderated by age, gender, or severity of posttraumatic stress, although there were several exceptions. These data suggest that non-parent caregiver and teacher agreement of emotional and behavioral problems in traumatized youth is low but comparable to agreement between parents and teachers. Assessment and treatment implications are discussed. [ABSTRACT FROM AUTHOR]

This study was undertaken to investigate the treatment outcome differences between youth offenders from the joint commission accredited residential treatment center (RTC) and youth from a non-accredited center. Results showed that youth from the accredited center reported significantly more progress. [ABSTRACT FROM AUTHOR]

The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental health disorders, depression in particular, though youth also reported a sense of well-being and a positive outlook for the future. Many youth were able to articulate the improvements in their mental health and functioning after accessing intensive mental health treatment. Youth also divulged perceptions of their treatment and care. Implications are discussed. [ABSTRACT FROM AUTHOR]

Over time, residential mental health treatment programs for youth with serious emotional and behavioral disorders have shifted to a more family-focused paradigm that stresses the importance of family involvement during children's psychiatric care. Findings are presented from an in-depth qualitative examination of the factors that facilitate and hinder family involvement as well as expectations for family involvement from the perspective of providers at five residential youth treatment facilities in Florida. Results indicate that family involvement is facilitated by offering transportation assistance and flexible scheduling, fostering communication, and empowering families through education and support. Suggestions for future research are also offered. [ABSTRACT FROM AUTHOR]

The increasing ethnic, cultural, and class diversity in the United States calls for a proactive approach in helping youth develop into socially competent adults. Youth in residential treatment may exhibit deficits in perspective-taking ability, social competence, and relationship skills, which are important outcomes of healthy diversity attitudes. For some, the milieu may be their first experience with youth of diverse backgrounds. However, little is known about this topic. The purpose of this study was to explore diversity awareness, attitudes, and skills of youth in residential treatment. The current study highlights the need for diversity education programs within treatment. [ABSTRACT FROM AUTHOR]

Copyright of Discourse: Journal of Childhood & Adolescense Research / Diskurs Kindheits- und Jugendforschung is the property of Verlag Barbara Budrich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Youth with fetal alcohol spectrum disorders (FASDs) are in a perilous circumstance. FASD is associated with a high rate of self-regulation problems and trouble with the law and is underdiagnosed. Standard juvenile corrections-based interventions often do not meet the needs of these vulnerable youth. This article describes what is known about conduct-disordered adolescents with FASD and the neurocognitive deficits that directly affect emotional and behavioral self-control. The authors propose guidelines for the assessment of FASD within residential treatment settings and analyze interventions that show promise for inpatient treatment of youth with FASD. [ABSTRACT FROM AUTHOR]

Research on the correspondence between adolescent and parent reports of adolescent substance abuse has typically been conducted on adolescent outpatient treatment samples, or on non-treatment samples. In the current study, fifty adolescents receiving residential substance abuse treatment, and their parents were assessed separately regarding the teen's substance use (e.g., cigarettes, alcohol, marijuana, other illicit drugs) during the 90 days preceding adolescent treatment entry. Correspondence between reporters was for the most part fair to excellent, with observed discrepancies generally due to parents providing lower estimates of use than did adolescents. Multiple regression analysis revealed that higher discrepancy between reporters occurred when the parent was younger, when the parent encountered fewer problems due to the teen's substance use, when the adolescent attended more probation or parole meetings, the fewer the number of days the adolescent was incarcerated, and the fewer days the adolescent lived at home prior to treatment. Results from exploratory analyses suggest that parents and adolescents are more discrepant when the assessment occurs later in the adolescent's treatment program. Overall, results suggest that in the absence of a cooperative teen, parental report of the adolescent's previous substance use could serve as a good proxy among families in which the adolescent is entering residential substance abuse treatment. [Copyright &y& Elsevier]

Abstract: Background: Young adulthood represents a key developmental period for the onset of substance use disorder (SUD). While the number of young adults entering treatment has increased, little is known about the mechanisms of change and early recovery processes in this important clinical population. This study investigated during-treatment change in key therapeutic processes (psychological distress, motivation, self-efficacy, coping skills, and commitment to AA/NA), and tested their relation to outcome at 3 months post-treatment. Methods: Young adults undergoing residential treatment (N =303; age 18–24; 26% female; 95% Caucasian) were enrolled in a naturalistic prospective study and assessed at intake, mid-treatment, discharge, and 3 months following discharge. Repeated-measures and regression analyses modeled during-treatment change in process variables and impact on outcome. Results: Statistically significant medium to large effect sizes were observed for changes in most processes during treatment, with the exception of motivation, which was high at treatment intake and underwent smaller, but still significant, change. In turn, these during-treatment changes all individually predicted 3-month abstinence to varying degrees, with self-efficacy emerging as the sole predictor in a simultaneous regression. Conclusions: Findings help to clarify the mechanisms through which treatment confers recovery-related benefit among young adults. At treatment intake, high levels of abstinence motivation but lower coping, self-efficacy, and commitment to AA/NA, suggests many entering treatment may be “ready and willing” to change, but “unable” to do so without help. Treatment appears to work, in part, by helping to maintain motivation while conferring greater ability and confidence to enact such change. [Copyright &y& Elsevier]

This study examined outcomes with 170 children and youth admitted to residential treatment with complex mental health problems. Overall, outcomes at 2 years post-treatment was predicted by children and youth's behavioral pretreatment status reflected in lower internalizing and externalizing behavior at admission. These findings recognize a cluster of variables upon admission that are differentially predictive of specific outcomes. Higher school participation/achievement and an absence of witnessing interparental abuse predicted educational status. Family status was predicted at admission by higher family functioning, being younger in the family, and children and youth who had poor community behavior. The results are discussed as they relate to pretreatment screening and the need to evaluate service outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Awareness of the sexual exploitation of children and adolescents is growing in the United States. Yet, very few studies have examined successful treatment options and outcomes for this population. In response to this gap, this descriptive case study provides a brief history of treatment programs for sexually exploited adolescent girls at a residential treatment center in New England, followed by detailed information about the admission process, treatment protocol, daily life, and outcomes of the most recent group home program. Compared with an earlier treatment program at the same facility, during its first year of operation this group home had a 78% decrease in the number of young women who failed to complete treatment goals due to running away, hospitalization or incarceration (p=<.05). Possible reasons for this difference in outcomes include using the transtheoretical model to guide admission decisions, and the practice of admitting youth to a more-restrictive on-campus program before moving them to the less-restrictive group home. [Copyright &y& Elsevier]

Abstract: The aim of the present study was to examine the treatment progress of both adolescent''s and their families'' functioning in a new compulsory residential treatment program. The sample consisted of 339 admitted adolescents (56.3% boys). The mean age at time of entry was 15.69 (SD =1.30). Adolescents stayed on average 9.42months (SD =4.66) in a new residential treatment program. Data on adolescents'' internalizing and externalizing problems were assessed using self-reports, parent reports, and group care worker reports. In addition, adolescents reported their substance use and delinquency and parents also reported family functioning and level of perceived parental stress. The findings revealed a significant decrease in adolescents'' self-reported internalizing and externalizing problems, delinquency, and substance use. According to parent ratings, a significant improvement was found concerning adolescents'' problem behaviors during treatment. However, according care worker ratings, adolescents showed no improvement on internalizing problems and showed an increase in externalizing problems. Concerning families, although there was no improvement in family functioning, parental stress significantly improved over time. Further research should examine whether improvements experienced during treatment are maintained after treatment. [Copyright &y& Elsevier]

This research examined deviant talk during summer residential treatment using peer nominations and extensive field observations. Participants were 239 youth ( M = 12.62, SD = 2.60; 67% male), nested in 26 treatment groups. Deviant talk was present in this setting, showed individual differences, and increased over time, especially for younger boys. As expected, its relationship to treatment response was moderated by peer behavior. Initial levels of individual deviant talk were related to clinical improvement, but primarily when peer deviant talk was low. Initial levels of peer deviant talk were related to higher than expected end of treatment aggression, especially for youth who were high in deviant talk. Deviant talk effects were observed for staff impressions of change and observations of aggression and adjustment. Initial antisocial behavior affected whether individual or peer levels of deviant talk more heavily influenced treatment response. Implications for clinical assessment and treatment monitoring are discussed. [ABSTRACT FROM AUTHOR]

Residential treatment facilities operate under increased pressure to demonstrate outcomes, yet little is known about the outcomes monitoring practices of such facilities. This study analyzed data from a survey of residential treatment facilities to examine the extent to which residential treatment facilities monitor outcomes after discharge. Sixty-nine percent of facilities measured satisfaction with residential treatment after discharge; roughly half measured the use of mental health services, housing status, school performance, and/or clinical functioning after discharge. Facilities that were licensed by the state had 2.17 higher odds (95% CI: 1.22–3.84) of measuring at least one of these outcomes after discharge. Most facilities that measured outcomes did so for no more than sixmonths after discharge. Continued efforts are needed to encourage the monitoring of outcomes after discharge from residential treatment. [ABSTRACT FROM PUBLISHER]

This study used a multimethod approach to evaluate the relationship of alexithymia (as measured by the 20-item Toronto Alexithymia Scale and the 30-item Emotion Awareness Questionnaire), psychosocial development (assessed with the Measure of Psychosocial Development), and risk behavior (as measured by the Youth Comprehensive Risk Assessment) in 67 adolescents (85% from rural communities) in a rural residential treatment facility. Results revealed that both measures of alexithymia demonstrated good internal consistency and convergent validity. The EAQ-30 demonstrated stronger convergent validity over the TAS-20 with psychosocial measures of shame, inferiority, and role confusion and was more robust in differentiating risk behavior among males and females. Adolescent females scored higher on measures of alexithymia than males and demonstrated significantly more shame, diminished bodily awareness, and risk to self; whereas, males demonstrated significantly more risk to others. Overall, this study contributes to the current literature of alexithymia, provides further support for the validity of the alexithymia construct with adolescents, and sheds light on the importance of emotional awareness and expression in adolescent psychosocial development. Although exploratory, this study also increases clinical understanding of how risk behavior develops and manifests differently in male and female adolescents, specifically with regard to shame and diminished bodily awareness. [ABSTRACT FROM AUTHOR]

This study used data from a national survey of residential treatment facilities and conducted interviews with stakeholders in systems of care that serve children and youth with serious emotional disturbances to examine the extent to which youth and families participate in the governance activities of residential treatment facilities. Twenty percent of residential treatment facilities included youth and families in some type of governance activity, such as serving on the board of directors or participating in quality assurance. Thirty-eight percent of residential treatment providers agreed that licensing or accreditation standards should require the participation of youth and families in facility governance, and these facilities were more likely to have adopted treatment practices consistent with a commitment to partnering with youth and families in the delivery of services. These practices include unrestricted visitation and allowing youth and families to select their treatment team. Residential treatment providers and other stakeholders in systems of care identified several challenges to engaging youth and families in facility governance and proposed solutions for overcoming them. Further work is needed to encourage and monitor the participation of youth and families in the governance of residential treatment. [ABSTRACT FROM AUTHOR]

This article outlines the importance of assessing both within-child and environmental strengths for children and adolescents admitted to residential treatment facilities (RTFs). Discussed are the theoretical underpinnings behind strength-based assessment, as well as a number of organizations and initiatives that aim at raising the bar for children's care, creating a holistic viewpoint. Assessments such as the BASC-2, ASEBA, and Vineland-II are well-established measures that have moved to meet these demands, and measures like the BERS-2, RSCA, and DESSA have an overt strengths orientation. The CASA and the DCASC are omnibus strengths measures that can be utilized to fill the “intake gap.” [ABSTRACT FROM PUBLISHER]

Abstract: This research identified psychosocial correlates of motivation to change in adolescents being discharged from residential treatment for substance use disorders. Using a naturalistic longitudinal design, adolescents in a residential treatment program in southeast Ohio were assessed at intake and discharge using self-administered questionnaires. Surveys assessed motivation to change one''s drug and alcohol use, ways of coping to avoid future alcohol/substance use, and social support. The 68 participants (mean age = 16.0, range = 12–18) were predominantly Caucasian (87%) and male (69%). Over the course of treatment, adolescents reported significant increases in active-cognitive coping, avoidant-behavioral coping, and attachment and marginally significant increases in motivation to change and reliable alliance. Adolescents who reported higher discharge levels of motivation to change also reported greater levels of social integration at discharge. Strengthening adolescents'' social integration may also increase their motivation to avoid using drugs and alcohol as they prepare to exit treatment and return to their home communities. [Copyright &y& Elsevier]

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 bi-weekly 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. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study was to evaluate the efficacy of solution-focused brief therapy (SFBT) in promoting foster care placement stability in an urban residential treatment facility. Thirty one adolescents with a history of multiple placements were compared to their first and second years in the facility. Cognitive behavioral therapy (CBT) was the preferred treatment method in year one; SFBT was the preferred treatment method in year two. Co-developer of solution-focused brief therapy trained the staff for a week followed by three-day trainings at three and six months. The number of disruptions in the teens'' year prior to staff training was compared to the number in the subsequent year. The mean number of disruptions decreased from M=6.29 (SD=3.6) to M=1.45 (SD=.68), p<001. It was concluded that solution-focused brief therapy has potential to promote foster care placement stability with adolescents. [Copyright &y& Elsevier]

This article reviews the literature published in the last 20 years on working alliance in adolescents involuntarily enrolled in intervention programs. Firstly, Bordin's adaptation of the concept of working alliance to adolescent populations is discussed. This is followed by an analysis of the main results of empirical studies on helping relationships in authoritarian settings. Finally, the results of these studies are used as the basis for a multidimensional (personal, interpersonal, contextual) model of working alliance in young people in authoritarian settings. A key conclusion of this article is that differences in intervention context are essential to the understanding of the establishment of working alliance in young people. A dyadic vision of working alliance (patient/therapist) does not appear to significantly advance the theory of clinical practice. [ABSTRACT FROM AUTHOR]

To date, there is limited information regarding prevalence of health-related risks profiles of youths in psychiatric residential treatment, including weight and physical activity. To address this gap in the literature, weight and associated health risk behaviors in a sample of adolescents in a psychiatric residential treatment center were assessed. Adolescents in this sample have nearly twice the rate of being overweight or obese (46.6%) when compared to national (28.8%) norms and only 47.8% met national physical activity recommendations. Adolescent psychiatric residential treatment facilities are poised to intervene with adolescents who are at high risk for unhealthy weight. [ABSTRACT FROM AUTHOR]

This study examined the admission characteristics associated with failure to complete residential substance abuse treatment among male adolescents. Of 160 admissions, 48 (30%) completed treatment. Having commercial health insurance (P= .005), having a family history of a substance use disorder (P= .05), and living with only one biological parent (P= .015) were admission characteristics associated with non-completion. Those reporting a history of physical or sexual abuse also appeared to be at risk for non-completion (P= .014); none of these participants completed the treatment. Interventions that improve residential substance abuse treatment retention for adolescents are needed. [ABSTRACT FROM AUTHOR]

Family-driven, youth-guided practices have shaped the development of community-based mental health services for children and youth; however, the extent to which residential treatment providers have adopted these practices is unclear. This study reports the findings from a survey of 293 residential treatment providers conducted to examine the adoption of family-driven, youth-guided care. Residential treatment providers reported several practices consistent with family-driven, youth-guided care, including strength-based individualized treatment planning, collaboration with community-based providers to develop treatment plans, and the provision of various forms of support to families. Thirty percent of providers reported that the youth or family member was the primary decision maker in the development of treatment plans, 20.9% included youth or family members in program oversight, and 88.0% reported that staff had not heard of family-driven, youth-guided principles or required further training to implement them. [ABSTRACT FROM AUTHOR]

Early identification of youth who will exhibit the most challenging behavior during the course of a residential stay would allow clinicians to allocate limited resources to best manage these youth. Seclusion/restraint procedures were examined for 156 youth in two public residential facilities from July 2000-September 2005. Few seclusion/restraints occurred in the first month, but this peaked in months two and three. Youth subgroups with different trajectories for the frequency of seclusion/restraint use were distinguishable by the first 60 days. By the second month in residence clinicians can identify youth who will continue to exhibit challenging behavior. [ABSTRACT FROM AUTHOR]

The present study examined the impact of an in-patient addiction treatment program and whether client-related treatment outcomes were moderated by addiction type: (1) alcohol only; (2) cocaine only or with alcohol; (3) cocaine with other substances; and (4) prescription drugs and/or cannabis. Clients completed self-reports of their substance use and quality of life during their first week in treatment and at 6-months post-discharge. Pre-treatment motivation and post-treatment aftercare attendance were also assessed. Overall, a positive impact of the addiction treatment programme was noted as clients reported a significant reduction in substance use and improvement in quality of life. Results also demonstrated that drug of choice impacted recovery status such that compared with cocaine poly substance clients, alcohol clients obtained significantly higher scores on quality of life measures at both pre- and 6-months post-treatment. However, cocaine poly substance clients were also significantly younger than alcohol only clients and were less likely to be married or employed. In general, substance use clients responded well to treatment. Some variability was noted among substance use groups—namely that cocaine poly-drug users obtained lowest levels of post-treatment reduction in substance use. The implications of such findings are discussed. [ABSTRACT FROM AUTHOR]

This study examined the impact of protective factors, assessed by means of the Structured Assessment of Violence Risk in Youth (SAVRY), on desistance from violent reoffending in adolescents. Three samples included male adolescents in different stages of the judicial process: pre-trial (n = 111); during residential treatment (n = 66); and after release from a juvenile justice facility (n = 47). The results lend support to the hypothesis that protective factors buffer or mitigate the risk of violent reoffending. Using regression analyses, in all samples, the addition of protective factors yielded a significant increment in the amount of variance explained by dynamic risk factors alone. Furthermore, in medium to high risk subgroups, the violent reoffending rate was significantly higher when protective factors were absent, compared to when protective factors were present. These findings are discussed in terms of their implications for risk assessment and risk management practice with adolescent offenders. [ABSTRACT FROM AUTHOR]

Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A onegroup pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58 youth between the ages of 9 and 18. Outcome measures included Child and Adolescent Functional Assessment Scale (CAFAS) and the Abel Assessment for Sexual Interest-Adolescent (AASI). Results: The results indicate significant improvement from pretest to posttest scores. Length of stay was not found to influence these impacts. Conclusions: The applications of these results to understanding the effectiveness of residential treatment for sexually abusive youth and the assessment of treatment outcomes for these youth are explored and discussed. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the predictive validity of the Washington Circle (WC) continuity of care after long-term residential treatment performance measure, as well as the impact of assertive continuing care interventions on achieving continuity of care. This measure is a process measure that focuses on timely delivery of a minimal floor of services that are necessary to provide sufficient quality of treatment but should not be construed to be the optimal continuity of care after residential treatment for any specific adolescent. Participants included 342 adolescents who were admitted to long-term residential treatment and randomly assigned to either standard continuing care or an assertive continuing care condition. Overall, results provide initial support for the WC continuity of care after residential treatment performance measure as a useful predictor of 3-month recovery status. In addition, assignment to an assertive continuing care condition was found to significantly increase the likelihood of achieving continuity of care. [Copyright &y& Elsevier]

Abstract: Telephone continuing care (TCC) was compared to usual continuing care (UCC) on substance use and related problems among adults discharged from residential treatment. Participants were randomly assigned to receive either UCC or TCC. A tapered TCC protocol, initiated by paraprofessional staff and volunteers, was provided during the first 3 months following discharge. The TCC condition participants reported high satisfaction ratings with the procedure and were more than twice as likely to enter continuing care than UCC participants. At the 3-month point, TCC patients reported significantly fewer past-month substance problems than UCC patients. Among the subgroup of lower severity (LS) participants, the TCC-LS sample had both significantly more days abstinent and fewer past-month substance problems at 3 months than the UCC-LS sample. The significant between-group differences in substance use outcomes were not maintained at the 6-month follow-up. The high satisfaction ratings and early favorable response among TCC patients suggest the procedure is promising. Further research with larger samples and over a longer period is necessary. [Copyright &y& Elsevier]