Residential Treatment Group Research Articles

Residential treatment for homeless female veterans with psychiatric and substance use disorders: Effect on 1-year clinical outcomes

Limited evidence shows that time-limited residential treatment (RT) is beneficial for homeless people with serious mental illness. The Department of Veterans Affairs has established 11 specialty programs for homeless female veterans. We present data comparing 1-year clinical outcomes in a group of veterans who did and did not receive at least 30 days of RT. Clients of the Homeless Women Veterans Programs were invited to participate in a follow-up study. They were interviewed every 3 months for 1 year. Those who received at least 30 days of RT in the 3 months after program entry (RT group) were compared with other program participants (no or <30 days RT [NRT] group) on measures of community functioning, psychiatric symptoms, and drug and alcohol use during the follow-up. The RT group had better outcomes on employment, social support, housing status, and psychiatric symptoms. They also had significantly increased use of drugs and alcohol compared with the NRT group. Data suggest that RT may have a beneficial effect on mental health outcomes in homeless women. This study, in conjunction with others, suggests that provision of stable housing may be an important element of recovery for homeless women with psychiatric problems, excluding substance use.

Therapeutic communities for substance related disorder

Therapeutic communities (TCs) are a popular treatment for the rehabilitation of drug users in the USA and Europe. To determine the effectiveness of TC versus other treatments for substance dependents, and to investigate whether effectiveness is modified by client or treatment characteristics. We searched: Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2005); MEDLINE, EMBASE, Psycinfo, CINAHL, SIGLE from their inception to March 2004. Reference lists of studies were scanned. Randomised controlled trials comparing TC with other treatments, no treatment or another TC. Two authors independently inspected abstracts, the methodological quality was assessed using Drug and Alcohol CRG checklist. When possible, data were summarised using relative risks and differences in means, otherwise results are presented as reported by authors. Seven studies were included. Differences between studies precluded any pooling of data, results are summarised for each trial individually: TC versus community residence: no significant differences for treatment completion; Residential versus day TC: attrition (first two weeks), and abstinence rates at six months significantly lower in the residential treatment group; Standard TC versus enhanced abbreviated TC: number of employed higher in standard TC RR 0.78 (95% CI 0.63, 0.96). Three months versus six months programme within modified TC, and six months versus 12 months programme within standard TC: completion rate higher in the three months programme and retention rate (40 days) significantly greater with the 12 months than 6 months programme. Two trials evaluated TCs within a prison setting: one reported significantly fewer re incarcerated 12 months after release from prison in the TC group compared with no treatment, RR 0.68 (95% CI 057, 0.81). In the other, people treated in prison with TC compared with Mental Health Treatment Programmes showed significantly fewer re incarcerations RR 0.28 (95% CI 0.13, 0.63), criminal activity 0.69 (95% CI 0.52, 0.93) and alcohol and drug offences 0.62 (95% CI 0.43, 0.90) 12 months after release from prison. There is little evidence that TCs offer significant benefits in comparison with other residential treatment, or that one type of TC is better than another. Prison TC may be better than prison on it's own or Mental Health Treatment Programmes to prevent re-offending post-release for in-mates. However, methodological limitations of the studies may have introduced bias and firm conclusions cannot be drawn due to limitations of the existing evidence.

Creating a Peer-Directed Environment: An Approach to Making Residential Treatment a Unique Experience by Using the Power of Peer Groups

The creation of a safe and healthy environment, the establishment of an atmosphere of trust, and the use of a residential treatment group as a powerful force in order to achieve behavior modification of its individual group members—these are the intentions that moved me to undertake the challenge of adopting a peer group methodology, originally designed for work with delinquent adolescents, to a younger, more emotionally disturbed population. I did so during my affiliation with ILEX (International Learning Exchange in Social Education) and the Edgewood Children’s Center in San Francisco 1999/2000. The following article will present how I introduced and established this group methodology, “Positive Group Interaction” (PGI), to my residence unit in the course of a year as the basis of that unit’s approach to working with its children. All observations are based on the specific group setting I worked in.

The Impact of a Juvenile Residential Treatment Center on Minority Offenders

This study compares postrelease behavior of youth released from a residential treatment center to a similar group of youth discharged from traditional juvenile institutions. The hypotheses tested are (a) non-White youth are more likely to be reconvicted of a new offense and recommitted than are White youth regardless of the type of facility, (b) non-White youth in a residential treatment facility are less likely to be reconvicted of a new offense or recommitted than are non-White comparison youth, and (c) White youth in a residential treatment facility are less likely to be reconvicted of a new offense or recommitted than a comparison group of White youth. Regardless of race, the residential treatment group has a lower percentage of reconvictions and recommitments than the comparison group. Minority offenders in a residential treatment facility are less likely to be reconvicted or recommitted than minority offenders in the comparison group. These findings have implications for future correctional endeavors.

Drug Treatment for Juvenile Offenders: Some Good and Bad News

Approximately 700 substance-abusing youthful offenders were assigned to either a two-month residential substance abuse treatment program group or a comparison group. Upon completion of the program, the residential treatment group youths were placed in either the treatment or comparison group for a four-month community aftercare phase. Youths who participated in the residential portion of the program reported significantly decreased drug use and delinquency and increased cognitive decision-making skills and demonstrated a longer period of time from entry into the study until rearrest than control youths. Results for the aftercare segment of the program show that the positive gains made while in the residential program were not bolstered through aftercare. Aftercare youths reported more delinquent behavior and demonstrated more participation in drug-related crime than control subjects. Aftercare youths did, however, exhibit less participation in crimes of an interpersonal nature.

Performance of delinquent and nondelinquent high schools boys on the Rotter Incomplete Sentence Blank.

This study compared 30 delinquent adolescent boys who had been placed in a residential treatment center with 30 randomly selected high school boys on the Rotter Incomplete Sentence Blank (Rotter). For each group a maladjustment score was computed. The results indicated a significant difference between the two groups' mean maladjustment scores on the Rotter. A cut-off score was established that made it possible to correctly identify 73% of the normals and 60% of the residential treatment group. An item analysis was carried out between the two groups to see whether certain sentence stems discriminated between the two groups. Fourteen sentence stems were found to discriminate significantly between the groups. From these sentence stems a short form of the Rotter was established with a revised maladjustment score that correctly identified 82% of the boys in each group. A cross-validation of the short form with 48 high school boys and 67 delinquents supported its use as 75% of the high school boys and 80% of the delinquents were correctly identified.