Essay Example on Residential Treatment Centers (RTCs): Evolution of Care for the Mentally Ill

Introduction

A residential treatment center (RTC), so-called a rehab, is a facility rendering therapy for drug abuse, psychopathy, or behavioral psychology related problems. RCTs have seen a transition over time. In the 1800s, mentally ill teenagers were confined together with adults due to a lack of proper structure and know-how to handle them. (Callan, J., 1976). The major reason for this was due to a lack of residential treatment centers (RTCs) in existence, providing all-time care, and the victims could not live in their homes. Psychoanalytic Societies focused on the creation of RTCs for children and teenagers with both emotional and behavioral disorders date back to the 1900s (Cohler et al., 2004). Adolescents with serious alcohol addiction need specialized care through professional treatment addressing their physical, mental, emotional, and spiritual developments. In a residential treatment center, the adolescents are given mental health, addiction, and drug abuse sessions. They are taught the need to be responsible for life to be able to deal with real-life issues such as addiction. Behavioral interventions have been fruitful in reducing behavioral problems in RTCs. Such intervention is productive even if meditational intervention is not incorporated. Interventions such as response assessment, social skills training, and positive social support increase pro-social Behavior among teens.

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By the 1980s, cognitive behavioral therapy was the most commonly applied in children's psychiatry as a means of intervention in RTCs for improved outcomes (Cohler et al., 2004). In the 1990s, the number of adolescent RTCs increased. This led to a policy change towards family-centered community care. In adolescent RTCs, behavioral adjustment prototype is employed. RTCs have different approaches and structures. In a lock-down facility, residents are confined within the premise with restriction of movements. On the flipside, unlocked RTC provides room for free movement, but adolescents cannot leave the center. These centers are centered on providing behavioral management and treatment for adolescents with severe problems. The number of RCTs has been ballooning over time with new structural and organizational adjustments. Current RTCs receive rallies from behavioral psychologists in a bid to improve the results and minimize unethical practice (Houston, M., 2010). According to Foltz (2004), the most common grounds for admission are:

• Emotional disturbances, such as post-traumatic stress disorder (PTSD), anxiety disorder, attachment disorder, and self-destructive behaviors.
• Aggressiveness or violent Behavior.
• Family or school or community-related problems.
• Abuse. Which may include physical, sexual, or emotional abuse. Such abuses have been associated with PTSD leading to admission.

Past studies have shown that these RTCs leads to positive outcomes for the adolescent (Smith et al., 2008). Despite the services provided to the adolescents in our RTC, with an expectation to provide improve outcomes, several problems related to the delivery of group and recreational therapy services to the residents have become evident. Residents are not opening up during group process meetings, which might be linked to a lack of trust or cohesion in the group. Additionally, when reporting during individual therapy sessions, residents find it difficult to describe how the recreational therapy activity for the week has helped them with the resolution of their issues. After the recreational therapy activities, many of the residents are also complaining about pain in their muscles. Such issues have to be addressed to achieve the ultimate goal of our RTCs.

There is little literature on understanding how attitudinal changes in residents influence their behavioral change. There is a need for more evidence-based practice through research to demonstrate the causes of such issues. An understanding of the issues leading to such problems will help in laying down mitigation strategies. We, therefore, propose to carry out research to answer the research question; why are many of the residents in residential treatment centers not paying attention during group processing meetings? The findings will, therefore, help in advocating for the proper implementation of more efforts in our RTC. The programs differ from approaches and attributes. This research aims to conduct an examination of individual characteristics and the use of intervention methods such as adventure therapy. It aims to establish the measure of a score by residents through statistical analysis to determine what affects the concentration of adolescents during group meetings. The methods of delivering the lessons to participants in the RTCs will be explored and contributions to their betterment.

Population of study

The study will employ a total sampling procedure targeting all the youth in RTC (residential treatment centers). The participants are majorly aged between five to eighteen years. The main participants, however, are participants in the group meetings convened at the center. It will include the participation of teachers at the institutions who administers the lectures and executing self-evaluation. The study will not cover all the youth at the center; instead, it will concentrate on youth who attend the seminars to determine ways of improving the delivery of sermons for the youth chosen randomly. An investigation will be carried on the whole group to determine the criterion of random selection, keeping in mind its heterogeneity. Given the group is heterogynous, a stratified random sampling technique will be in use to divide the group into numbers depending on their importance to the investigation. The proposition is to divide the residents into groups by age, education level, and condition. From each group, a random sample of k =15 from each group will be selected from each group. Therefore examine a total of 45 participants.

Research Question:

Why are many of the adolescents not paying attention during group process meetings?

Attention is very vital in ensuring a message is understood. The research question is very important for the success of the program as it offers direction for tailoring objectives for the study. The research questions in this study were based on the reviewed literature. According to Lakin et al., (2008), burnout entails three aspects: emotional exhaustion, depersonalization, and Lack of personal accomplishment. Other aspects from reviewed literature are educational level and empath from staff members. Based on this, we propose to answer the question, "Why are many of the residents not paying attention during the group processing meetings?" based on these aspects. This study, therefore, intends to examine variables such as demographic characteristics of residents, education level, and empathic concerns as predictors of Lack of concentration by residents

Literature review

Residential treatment centers for adolescents have a varying approach to how they handle youth in their residences. A study by Brown et al. (2019) depicts a difference in a variety of factors such as qualification, treatment, and organization of RTC that affect the delivery of service. There is also a wide category of psychopathology among adolescents. External support from the parents and community can vary from among residential centers. These variations create inconsistency in the kind of care adolescents receive. The fulfillment of needs is varied, and an adolescent who transfers from one RTC to the other can have difficulties in adjusting to the new environment. These factors reduce the success of treatment and evaluating the overall success of the RTCs. From the research, it is not clear what aspects of the program are beneficial to the youth.

Varied treatment options put forth different outcomes depending on the services offered. A study on the effectiveness of the RTCs shows varying results. Through examining a total of thirteen students and an analysis of previous research by Stead et al. (2017) found that therapeutic interventions are beneficial when administered to individual participants, but there are limits on the effectiveness of the methods in group clusters(Stead et al., 2017). There are limited evaluation and description studies that shed light on the challenges faced by RCTs. There are no parameters for the measurement of program success that makes it hard to formulate a particular approach favorable to all participants. The study shows the necessity of restructuring the RCTs and tailoring it to satisfy the needs of every participant.

A study on the impact of private residential treatment programs, by Behrens and Satterfield's (2006) while studying 993 youths found a significant positive change in youths' Behavior from admission to discharge. The program has also had critics from experts and industry observers on the effects of taking adolescents in environments such as the RCTs, especially on their mental well-being. Most youths are comfortable with the home environment, and the residential treatment centers provide a challenge for the youth committed to such institutions. Research by Slayter (2016) shows a negative effect of placing youths with different mental needs in the same place with less restrictiveness (Slayter, 2016). There are changes within an individual that occur upon separation from parents or a familiar environment. Transferring adolescents from their homes can increase the level of depression and even increase violence. It reduces reception, concentration, and retention of the intervention methods offered at the residences

Conclusion

The research further points out the huge cost of moving the youths into these centers, making it difficult to deliver quality intervention methods to adolescents. It further presents alternatives to the RCTs that will better serve the youth and reduce the amount of money being spent by the government. It clearly shows the need for more research in the area to improve the current RCTs or come up with a better strategy to address the issue. The study on the RCT program indicates a significant reduction in risk for adolescents receiving treatment, but it also has an array of disadvantages on the adolescent inhibiting uptake of the intervention measures. This study will focus on RTCs where the adolescent resides together as "residents" and receive a combination of treatment approaches aimed at fostering an interpersonal relationship. Disability rights organizations question the appropriateness and efficiency of the RTCs. They cite the failure of such programs to address issues in the child's home and community environment. Issues pinpointed to RTCs include inappropriate disciplinary techniques, medical negligence, restrictions of communication, inadequate child protection, and Lack of monitoring and regulation.