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Purpose: Due to the ethical concern around involuntary treatment, this study sought to investigate if youth participants in wilderness therapy who were transported to the program experienced different rates of change than those not transported. Methods: Multilevel modeling techniques were used to investigate rates of change for youth between transported and nontransported youth over 5 points until 6 months postdischarge. In addition, repeated measures analyses of variance investigated parent reports of change over time across transport status, gender, and diagnosis. Results: The findings showed no differences between transported and nontransported youth in changes over time. Overall, all youth improved significantly with changes maintained postdischarge regardless of transport status. Discussion: This study shows that transporting youth to treatment does not appear to interfere with the treatment outcome; however, more research is needed to understand clients' perception of the transport process.

More than three quarters of all children orphaned by AIDS live in sub‐Saharan Africa. Significant portions of these children live in institutions. This study explores institutional caregivers’ views of children's psycho‐social needs. The authors gathered qualitative data from 92 staff at eight orphanages in the Ashanti region of Ghana. Results suggest that while staff's descriptions portray some understanding of children's psycho‐social needs, they suggest a possible deficit in organisational training or resources to adequately address these needs. Such findings warrant strengthening of orphanage caregivers’ capacity to provide optimal orphan care. [ABSTRACT FROM AUTHOR]