ABSTRACT
An interagency evaluation of the treatment effectiveness of a speciality nursing home (NH) run as a therapeutic community (TC) for residents diagnosed with acquired immunodeficiency syndrome (AIDS) and substance abuse/dependence (SA/D) was conducted. A total of 79 chemically dependent men and women with AIDS were: (a) administered the Tennessee Self-Concept Scale (TSCS; Roid & Fitts, 1991) at initial testing (T(1)) and 8 months after their initial testing (T(2)); and (b) assessed on specific physical health indicators (i.e. , weight, CD-4 count, and viral load) and other treatment outcomes (e.g., abstinence) over the same two time periods. The TSCS results identified a valid and invalid TSCS test group and further distinguished among three subgroups of invalid responders. Significant improvements were observed from T(1) testing to T(2) testing on the TSCS, on the physical health indicators, and on other treatment outcomes. The need for additional and continued mental health services for this population was noted.
Subject(s)
Acquired Immunodeficiency Syndrome/nursing , Nursing Homes , Substance-Related Disorders/nursing , Therapeutic Community , Acquired Immunodeficiency Syndrome/psychology , Adaptation, Psychological , Adult , Aged , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Personality Inventory , Program Evaluation , Sick Role , Substance-Related Disorders/psychologyABSTRACT
Using its own resources, a follow-up outcome study of 83 out of 119 (70%) graduates from four therapeutic community programs at two inner-city sites was conducted using the Tennessee Self Concept Scale:2 (TSCS:2) and the Post-Treatment Follow-Up Survey (PTFUS). The TSCS:2 and the PTFUS were completed anonymously by the respondent graduates and collected by research staff independently of program administrative staff and clinical staff. On average, the graduates had completed all formal agency required treatment and had been living independently in the community for nearly 12 months at the time of follow-up. Graduates who participated in the study were separated into one of three TSCS:2 profile groupings: Valid TSCS Profile, Invalid Faking Good (FG), and Invalid Inconsistency, to provide a more meaningful analysis of their outcomes data. All three TSCS:2 groups had favorable outcomes; however, to the extent that PTFUS questions were less specific than more specific, the Invalid FG group self-reported more positive outcomes. Where the PTFUS questions were very specific and concrete, the Valid TSCS Profile group generally had the most favorable outcomes. Implications of these findings are discussed.
Subject(s)
Outcome Assessment, Health Care/statistics & numerical data , Self Concept , Social Adjustment , Substance-Related Disorders/therapy , Therapeutic Community , Adult , Employment/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Middle Aged , New York City , Personality Inventory , Program Evaluation/statistics & numerical data , Sampling Studies , Social Problems/statistics & numerical data , Surveys and Questionnaires , Urban PopulationABSTRACT
To determine how effective a modified therapeutic community (TC) with enhanced mental health staffing would be in treating mentally ill chemical abusing (MICA) clients in a "mainstream" program, Project Return Foundation, Inc. (PRF) conducted a treatment outcome evaluation study involving 438 residents. Client admissions were screened by mental health specialists for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnoses and then placed into one of three diagnostic groups: non-MICA; general MICA (not requiring psychotropic medication); and, severe MICA (requiring psychotropic medication). Clients were administered the Tennessee Self-Concept Scale (TSCS; Roid & Fitts, 1991) after admission and at 6-month intervals thereafter. Results indicated that: (a) the three diagnostic groups were significantly different at initial TSCS testing, with the non-MICA group evidencing the least lowest measures of self-esteem and lesser degrees of psychopathology; the severe MICA group had the lowest psychological scores; (b) all three diagnostic groups showed significant improvement in their TSCS scores after 6 to 7 months of treatment; (c) covariance analyses observed that the three diagnostic groups did not significantly differ at 6 month testing when the initial TSCS testing was taken into account; and, (d) significant gender differences on several TSCS scales were noted, in that women scored lower than men in self-esteem and higher than men in psychopathology. Research limitations and clinical observations are considered.
