Residential Treatment Center For Children Research Articles

"Deck the Halls with . . . Careful Planning" (The Management of Christmas in a Children's Residential Treatment Center)

In the United States, Christmas carries certain religious and secular meanings which are known to most children. The Impact of this holiday can be particularly relevant to the mood and behavior of those who are living apart from their families. Although sectarian agencies will interpret the winter holiday season differently than non-sectarian agencies, all are affected by additional stress during this period. This article suggests ways to anticipate and reduce the tension on residents and staff during this special time.

Implementing a parent involvement/parent education program in a children's residential treatment center

Two prominent trends in contemporary child welfare, permanency planning and the family-centered model of care, are old theoretical ideas that have had great difficulty in finding corresponding practice methodologies. This article presents a practical model and discussion of the strategy and tactics involved in the process of developing and implementing a family-centered model by providing an effective parent involvement program in the residential treatment setting. Both didactic and experiential components are suggested, with emphasis on the latter in the context of planned change and the needs of children, parents, staff, and agency administration.

The children's residential treatment center as a living laboratory for family members: A review of the literature and its implications for practice

In order to accommodate an increasingly needy population and to remain a viable service modality that meets the contemporary imperatives of permanency planning, child residential treatment needs to be re-examined and re-shaped. This paper reviews the literature and targets a new use for the institution that moves it from custodial care and residential treatment to a laboratory for family members to receive help in learning living.

Health insurance and psychiatry: one peer reviewer's perspective.

For more than twenty years, discrimination against psychiatry by the health insurance industry has been a painful issue, the subject of vigorous action by organized psychiatry. A major breakthrough was the decision by the Civilian Health and Medical Programs of the Uniformed Services (CHAMPUS) in 1967 to extend coverage for outpatient psychiatric service to military dependents. From 1967 to 1970, CHAMPUS expenditures for psychiatric services increased from $90,000 to $400,000. Large sums were paid paid to unaccredited facilities, notably residential treatment centers for children (Armstrong, 1977), thus raising legitimate concerns about quality of care and inappropriate utilization. A more fundamental issue intimidates insurers, the apparent vagueness of psychiatric concepts and criteria for clinical judgments in practice (Liptzin, 1974).

Editorial

Editorial Teachers and other professionals in the field of deafness are well aware that there have never been residential treatment facilities available for those youth who were severely psychologically disturbed. This gaping absence of services has been devastating to deaf children (and their families) needing help for mental illness. After all these years of nothing, Michigan has finally made a breakthrough. The Hawthorn Center (Northville, Michigan 48167), long an outstanding residential treatment center for children, has over the last decade worked closely with the Michigan School for the Deaf and other programs in the state. Through this consultation their staff saw a need for services. In response they have developed an inpatient and outpatient mental health program for deaf youth at the Center. Unfortunately, Hawthorn takes only Michigan residents. However, in trying to share with others the principles they use in working with mentally ill deaf youth, the Center has developed a film on their work (available through Mr. Jim Haring of the Center). St. Elizabeth's Hospital (Washington, D.C. 20032) has an inpatient treatment program for mentally ill deaf adults. It has taken some deaf adolescents due to the lack of treatment alternatives for these youth. The new program in Connecticut may offer services to youth in that state, and Maryland now has an outpatient service for deaf mentally ill patients. BUDGET CHAOS AND DEAFNESS The chaos which has characterized the development of the upcoming federal budget leaves most of us unclear about the ultimate effects the process will have on deaf people. The Rehabilitation Services Administration funds for longterm training in deafness were cut some 33% for fiscal year 1980 which was a greater reduction than that experienced for any other rehabilitation discipline. For example, the corresponding budget for blindness was only cut 1.5%. Unfortunately, federal budgetary and policy decisions in both education and rehabilitation are frequently made by bureaucrats or politicians who have no in-depth knowledge of deafness . The capriciousness of the process was vividly revealed in the Atlantic Monthly's article on David Stockman. LEGAL ISSUES The argument over who should pay for interpreting services for deaf college students continues to rage. A New Jersey Federal Court recently ordered the State Division of Vocational Rehabilitation, not Kean College, to pay in the case of Ruth Shomstein. Cases such as this illustrate another dimension of federal fiscal irresponsibility. When laws such as PL 94-142 and the V.R. Act of 1973 are passed dictating massive services without consideration of costs, the end result is money wasted. For example, if the Maryland Division of Vocational Rehabilitation (DVR) had to pay for interpreting services for all deaf college students in Maryland who requested interpreters, funds otherwise spent on more needy deaf clients would have to be diverted to college students. Until some coherent funding is developed for PL 94-142 and the V.R. Act of 1973, we will continue to have a situation in which federally passed legislation promises the "world" to handicapped people. At the same time expanding rights and services are being guaranteed by this gradiose legislation, the money to fund them is either not appropriated or else it is taken from existing funds for other already established programs for disabled persons. Whereas, the established programs had ways to set priorities which helped assure that the money was spent wisely, the court decisions growing out of PL 94-142 and the V.R. Act of 1973 make no pretense of even considering the economic effects of the verdicts. Thus, there is no prioritizing , only arbitrary court decrees which depend on who decided to litigate. It is ironic that the politicians and bureaucrats who conceive such irresponsible patently ridiculous financial foundations for legislation and programs for the disabled would never consider comparable plans for their own personal finances or the finances of their businesses. For handicapped children and adults the end result is that what sounds wonderful when enacted into law turns out to be a set of promises minus the collateral needed for implementation. Would it not be better to have more realistic legislation appropriately funded than the current deception of promising everything while appropriating for little or none of what is...

Integration of a behavior modification program into a traditionally oriented residential treatment center for children

The historical background and early contributions of the Emma Pendleton Bradley Hospital, the first psychiatric hospital for children in the United States, are described. The focus of this report is on the incorporation of the treatment modality of behavior modification into this traditional psychoanalytically oriented program. Beginning with exploratory studies in the mid-1960s, in recent years within the residential center there has been a separate Autistic Unit, in which the major treatment strategy is consistent application of behavior modification principles and programs. Changes that have occurred in the course of developing the behavior modification program are discussed to show some of the positive and negative aspects of introducing such a radical change into a traditional setting. Case studies are included to reveal both the failures and the successes that have been encountered in treating psychotic children with either psychotherapy or behavior therapy. Description of the current status of the program shows that treatment is comprehensive, including psychodynamic and behavioral approaches, medication when warranted, and special education. The role of parents in the program is now very different from that ascribed to them in traditional psychoanalytically guided treatment.

A salute to dedicated women.

Madam President, members and guests of the Crystal Chapter of the Asthmatic Children’s Foundation of Florida : Thank you for the privilege of speaking to you on the subject that we are mutually interested in-that of rehabilitation of the severely afflicted, intractable asthmatic child. When one realizes that in the United States one-third of all chronic conditions occurring in children under 17 years of age are caused by asthma, hay fever, and other allergies, it reflects on the seriousness and enormity of the problem. Nearly five million children suffer from chronic allergic disorders; and over 2% million of these have asthma of varying degrees of severity. About 300,000 children have intractable asthma. Ninety percent are manageable by properly instituted allergic measures. The remaining 10 percent, or approximately 30,000 asthmatic children, do not respond to modern therapeutic methods because of deep-seated emotional factors, uncorrected environmental conditions, and/or undetected special situations. Do children “outgrow” their asthma? It is a known fact that about 25 percent of asthmatic children do improve without any allergy treatment and no longer have asthmatic attacks. However, one does not know which child will fall into that 25 percent group. The tendency for allergic symptoms to become progressively worse if untreated has been documented frequently in the medical literature. If the parent, influenced by the unaware physician, permits the child to continue without allergy treatment, believing that he or she will “outgrow” the illness, harm may ensue. The end result may be an adolescent or adult who has complications of chronic pulmonary disease. In a study by the Children’s Bureau on “Illness in Children”, it was shown that over 25 percent of children with major allergies like asthma, hay fever, and allergic eczema continue to have symptoms, even a t 16 and 17. This is particularly true of those who have not been on allergy management. I would like to discuss several propositions which should be thought-provoking : Do we need an Asthmatic Residential Treatment Center for children? Yes, we do; for the compelling reason that a center such as ours reduces the incidence of life-threatening episodes of a type of grnve or malignant asthma known as status asthmaticus, prevents deaths, and importantly, teaches the

The application of a self-modeling procedure to modify inappropriate behavior: a preliminary report

B andura (1965) has advocated the use of modeling procedures to modify socially inappropriate behavior. Considering his suggestion, the authors utilized a self-modeling technique successfully to accomplish this aim with a 10-year-old asthmatic boy. Chuck, the S, was a resident at CARIH, a residential treatment center for children with intractable bronchial asthma. The S's behavior during the 16 months he had been at CARIH could be briefly described as immature and non-assertive. In his dormitory, for example, he spent most of his time alone reading comic books or viewing television. Attempts to join into activities with other children were usually rebuffed by comments that Chuck was a “boob” or “baby.” The S would then cry and retreat by himself to his room where he was apt to engage in a severe temper tantrum. This behavior was noted by the other boys who would renew their taunts. When around adults, on the other hand, Chuck giggled constantly. He frequently attempted to tickle the adult and, in an interview setting, he was prone to leap from his chair onto the interviewer's lap. Almost every morning Chuck overslept. This not only meant that he did not have enough time to make his bed or tidy up his room, but he would also fail to report to the dispensary on time for his medication. To modify these behavior patterns, a self-modeling procedure was used.

Restoration of eating behavior in anorexia nervosa through operant conditioning and environmental manipulation

A token system of reinforcement was employed to increase the rate of eating in a girl with anorexia nervosa. This token system increased eating rate when it was superimposed on the existing reinforcement-laden environment of a residential treatment center for children. In addition, during the entire course of the experiment (baseline R-1 R-2 R-3 R-4), the patient was receiving noncontingent reinforcement in the form of supportive therapy with a psychologist who allowed her to speak about current problems. No attempt was made to explore “dynamics” nor to perform what is often termed probing or depth therapy. In addition, a re-educational program for the parents assisted them in learning the methods being used at the Center and assisted them with the transition between Center and Community.

STATUS, ROLE, AND THE FUNCTION OF SUPERVISION IN THE RESIDENTIAL TREATMENT CENTER FOR CHILDREN

STATUS, ROLE, AND THE FUNCTION OF SUPERVISION IN THE RESIDENTIAL TREATMENT CENTER FOR CHILDREN