Systematic transition planning through family involvement, service coordination, and community involvement is critical for achieving change for youth with emotional and behavioral disorders in residential treatment centers (RTCs). Sixty-two individuals (21 staff members, 21 parents, and 20 adolescents) from an RTC were interviewed regarding these practices. Results indicated that the RTC involved adolescents and parents in discharge planning, taught youth skills for success in the community, and facilitated community involvement. However, other areas needed improvement, such as communication between the residence and the adolescents' home schools, more frequent and longer home visits, and aftercare services.
In order to improve post-discharge outcomes for children, it has been proposed that residential treatment centers place a greater emphasis on engaging families and building on strengths of the youths in treatment. This review presents the theoretical and empirical support for several promising strategies for engaging families, such as behavioral parent training, parent support groups, and systems approaches. Approaches to building on strengths, such as strength-based assessment, supporting social network relationships, adventure-based learning, and service learning are also reviewed. Suggestions are provided for integrating these approaches to construct a model residential treatment program.
We conducted interviews with staff members, parents, and adolescents at a residential treatment center to examine the frequency, nature, and satisfaction with contact between parents and adolescents and parents and staff. We also assessed perceived barriers to family involvement and possible solutions for improving this involvement. Results indicated that there is more contact between parents and adolescents than in previous studies. In addition, contact between parents and staff occurred frequently, although there were discrepancies regarding their reasons for the contact. Most parents and adolescents reported that the amount of contact was adequate, but the majority of staff members perceived there to be not enough contact. Adolescents reported that there was not enough contact with secondary sources of support, most often other family members. Barriers to family involvement included transportation, parent responsibilities and personal problems, and legal issues. In addition, parents reported that strained family relationships and problematic adolescent behavior interfered with their involvement. The need for residential treatment centers to broaden services to include parents as well as members of the larger support network is discussed.
Introduction
Diverticular perforation due to foreign body ingestion is an uncommon but important cause of gastrointestinal tract injury. The aim of this study is to discuss relevant findings seen in diverticulitis caused by foreign bodies and its treatment.
Case presentation
In this report, we present a case of a 30-year-old woman who presented to the emergency department with two days of severe abdominal pain and diarrhea. Computed tomography of the patient's abdomen and pelvis revealed micro-perforations of the sigmoid colon with pneumoperitoneum and an intraluminal foreign body. She subsequently underwent an exploratory laparotomy with sigmoid resection and end-to-end anastomosis due to acute diverticulitis complicated by feculent peritonitis. Gross examination of the excised specimen revealed two large perforations and an intraluminal chicken bone. After a six-day hospitalization, the patient was discharged with an excellent prognosis.
Discussion and conclusion
Prompt radiological evaluation and classification of the degree of diverticulitis using the Hinchey classification system in this patient helped guide definitive treatment. Usage of this classification scheme in foreign body diverticulitis is valuable in determining whether a surgical or non-surgical approach is necessary.
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