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EVALUATION OF REALITY THERAPY STRATIFICATION SYSTEM IN A RESIDENTIAL DRUG REHABILITATION CENTER

NCJ Number
56759
Journal
Drug Forum Volume: 7 Issue: 1 Dated: (1978--79) Pages: 59-67
Author(s)
R SCHUSTER
Date Published
1978
Length
9 pages
Annotation
A STRATIFICATION SYSTEM INVOLVING FOUR LEVELS OF ASCENDING RESPONSIBILITY AND PRIVILEGES WAS DESIGNED AND IMPLEMENTED FOR USE IN A MALE ADOLESCENT DRUG REHABILITATION CENTER.
Abstract
THE SYSTEM WAS IMPLEMENTED IN THE COOPER REHABILITATION CENTER IN NEW YORK. THE ADOLESCENTS ALL HAD DRUG/PSYCHIATRIC DISORDERS AND EXTENSIVE CRIMINAL RECORDS. THE SYSTEM DIVIDED THE FLOORS INTO FOUR LEVELS, AS THE YOUTHS DEMONSTRATED INCREASINGLY RESPONSIBLE BEHAVIOR, THEY WOULD BE ALLOWED TO ADVANCE THROUGH THE LEVELS. EACH LEVEL WOULD HAVE CONCRETE CRITERIA TO BE MET. THE GOAL OF THE STAFF DEVISED AND IMPLEMENTED A CONSISTENT TREATMENT APPROACH THAT PROVIDED CONTINUAL FEEDBACK TO THE RESIDENTS ENABLING THEM TO MASTER THE TASKS OF EACH LEVEL. THE PROBLEMS AND STRENGTHS OF THE SYSTEM WERE EVALUATED GIVING THE FOLLOWING CONCLUSIONS. THE SYSTEM HELPED TEACH RESIDENTS TO BE RESPONSIBLE FOR THEIR ACTS AND HELPED CONTROL NEGATIVE 'ACTING OUT' BEHAVIOR. COMMUNICATION BETWEEN WARD STAFF IMPROVED; RESIDENTS VIEWED THE SYSTEM POSITIVELY, FEELING THAT IT ALLOWED THEM MORE CONTROL OVER THEIR DESTINY, INSTEAD OF BEING SUBJECT TO ARBITRARY DECISIONS OF THE REVIEW BOARD. PROBLEMS WITH THE SYSTEM INCLUDED INCONSISTENCIES IN THE RULES WHICH ALLOWED RESIDENTS TO MANIPULATE IT AND LACK OF STAFF INVOLVEMENT WITH RESIDENTS. THIS WAS MAINLY DUE TO LOSS OF STAFF, MAKING MONITORING AND FEEDBACK DIFFICULT TO PROVIDE AND ALLOWED RESIDENTS TO SUPERFICIALLY FOLLOW THE RULES WITHOUT POSITIVE CHANGE. THE STAFF FOUND IT DIFFICULT TO DEVELOP CONCRETE CRITERIA FOR EACH LEVEL BECAUSE OF INSUFFICIENT STAFF TO WORK WITH THE RESIDENTS IN DEFINING AND DEVELOPING THE CRITERIA. OVERALL, THE STRATIFICATION SYSTEM WAS MININALLY EFFECTIVE. STAFF DEPLETIONS CONTRIBUTED MOST TO ITS FAILURE. RECOMMENDATIONS FOR FUTURE SYSTEMS OF THIS TYPE ARE (1) SUFFICIENT STAFF TO SUPPLY CONTINUAL FEEDBACK AND MONITORING, (2) PROPER TRAINING AND COMMITMENT AMONG THE STAFF, (3) PROGRAM SHOULD BE DIRECTLY SUPERVISED BY A HIGHLY TRAINED WARD STAFF PERSON IN AN ADMINISTRATIVE AND CLINICAL CAPACITY. REFERENCES ARE INCLUDED. (STB)