Therapeutic Wilderness Programs: A National Survey

1994 ◽  
Vol 17 (2) ◽  
pp. 49-53 ◽  
Author(s):  
Jennifer Davis-Berman ◽  
Dene S. Berman ◽  
Lynn Capone

Thirty one therapeutic wilderness programs specializing in mental health treatment were examined through both a mail survey and a telephone interview. Respondents provided information on sponsorship, type of clients served, outdoor modality, therapeutic modality, staff qualifications, and other professional issues. The results suggested that most programs were serving high-risk adolescents using a variety of outdoor modalities. Programs had a difficult time describing their therapeutic process, and there was a lack of research and follow-up in the programs. The lack of basic definitions of therapeutic, non-professional staff, and the lack of process and outcome research are discussed. Finally, the authors call for dialogue on these and other professional issues related to therapeutic wilderness programs.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fereidoun Azizi ◽  
Hengameh Abdi ◽  
Atieh Amouzegar

Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143.


2019 ◽  
Vol 7 (4) ◽  
pp. 520-544 ◽  
Author(s):  
Andreas C Goldberg ◽  
Pascal Sciarini

Abstract This article assesses whether—and to what extent—turnout bias in postelection surveys is reduced by adding a short nonresponse follow-up (NRFU) survey to a mixed-mode survey. Specifically, we examine how the NRFU survey influences response propensities across demographic groups and political factors and whether this affects data quality. We use a rich dataset on validated voter turnout data, collected across two different ballots. In addition to the main survey that comprises computer-assisted telephone interviews (CATI) and web respondents, both studies include a short follow-up mail survey for nonrespondents. The results demonstrate that collecting extra information from additional respondents on so-called “central” questions is worth the effort. In both studies, the NRFU survey substantially increases representativeness with respect to sociodemographic and participation variables. In particular, voters and politically active citizens are more accurately represented in the NRFU survey. This tends to result in better estimates of turnout determinants in the final (combined) sample than is seen from CATI/web respondents only. Moreover, the increase in response rate and the decrease in nonresponse bias comes at almost no price in terms of measurement errors. Vote overreporting is only slightly higher in the mail follow-up survey than in the main CATI/web survey.


2016 ◽  
Vol 65 (3) ◽  
pp. 215-222
Author(s):  
Rosemeri Siqueira Pedroso ◽  
Luciano Santos Pinto Guimarães ◽  
Luciana Bohrer Zanetello ◽  
Veralice Maria Gonçalves ◽  
Ronaldo Lopes-Rosa ◽  
...  

ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge) from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge), 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge), 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.


1973 ◽  
Vol 18 (3) ◽  
pp. 175-183 ◽  
Author(s):  
Nathan B. Epstein ◽  
Duane S. Bishop

In summary, it can be said that progress is being made in the field, but slowly. The ‘art’ is vigorous, vital and exciting. The ranks of family therapists are swelling and they are coming from backgrounds of different theoretical persuasions and with varying degrees of sophistication in their training and education. This mélange does lead to excitement and turbulence but often detracts from the necessary rigour that a scientific discipline must develop in order to reach maturity. Systems theory allows for easy conceptualization of one another's behaviour in the system, and permits a much clearer understanding of the therapeutic process based upon it, in contrast to therapeutic approaches based on other models. The authors found negotiation to be therapeutically effective when made explicit. In addition they place the focus on the ‘here and now’ and encourage the increased labeling by family members of interactions (affective and behavioural) and their effects (affective and behavioural), according to the Family Categories Schema previously referred to. Efforts are directed especially towards dealing with the current resistances to problem solutions. Epstein et al. have reported on an ongoing program of research which attempts to examine the process and outcome of family therapy (7,10,21,22,25,26). What is needed now is a more rigorous approach to research and the development of a necessary theoretical base in order that a more systematic and scientific approach can be developed for treating families.


2008 ◽  
Vol 22 (1) ◽  
pp. 68-79 ◽  
Author(s):  
Christin Langhoff ◽  
Thomas Baer ◽  
Doris Zubraegel ◽  
Michael Linden

The therapeutic alliance is seen as an important dimension in any type of psychotherapy. But patient, therapist, or observers can have different views on the therapeutic alliance. The question is which perspective best represents the therapeutic alliance, and what are the differences between these alternative views. In the present study, the therapist–patient alliance (TPA, the view of the therapist), patient–therapist alliance (PTA, the view of the patient), and mutual therapeutic alliance (MTA, the view of an observer) were measured simultaneously in cognitive behavior therapy of patients suffering from generalized anxiety disorder. Additionally, the concordance between patient and therapist ratings (TPC) was calculated. Cognitive behavior therapists attained high positive scores in all perspectives for all dimensions of the therapeutic alliance, such as empathy, cooperation, transparency, focusing, and assurance of progress. Correlations were consistently higher for ratings between therapist and patient than between observer and patient. A relation with outcome (Hamilton Anxiety Scale) was only found for observer ratings. It was concluded that cognitive behavior therapists can achieve good alliances with their patients. Different perspectives on the therapeutic alliance should be distinguished and taken into account separately in studies on the therapeutic process and outcome.


2021 ◽  
Vol 263 (1) ◽  
pp. 5804-5814
Author(s):  
Eric Jodts ◽  
Jean Opsomer

As part of the agency's broader noise research program, the Federal Aviation Administration (FAA) has undertaken a multi-year research effort to quantify the impacts of aircraft noise exposure on communities around commercial service airports in the United States (U.S.). The overall goal of the study was to produce an updated and nationally representative civil aircraft dose-response curve; providing the relationship between annoyance and aircraft noise exposure around U.S. airport communities. To meet this goal, the FAA sponsored a research team to help design and conduct a national survey, known as the Neighborhood Environmental Survey (NES). Residents from households around 20 airports were selected for participation in the survey; the detailed sampling process is covered in another paper. Two survey instruments were administered to adult residents within the NES: a mail questionnaire and a follow-up telephone interview for the mail respondents. The mail survey was administered to samples of individuals in the selected airport communities in six separate "waves" over a 12-month period starting in October 2015. All mail survey respondents were invited to complete a follow-up telephone interview, which asked detailed questions on several areas including respondents' opinions on noise, exposure to aircraft noise, relationship to the airport, concerns about aircraft operations, views on airport community relations, among others. Analysis of the survey responses on annoyance levels and the associated DNL was used to estimate dose-response curves for each individual airport and a national dose-response curve. The national dose-response curve created from the mail questionnaire shows considerably more people are highly annoyed by aircraft noise at a given noise exposure level compared to historical FICON data. This paper provides a detailed discussion of the survey design and methodology. Additional information describing the motivation to conduct the NES and how its findings will help inform ongoing work to address aircraft noise concerns; and the noise methodology are provided in companion papers.


1997 ◽  
Vol 78 (2) ◽  
pp. 140-155 ◽  
Author(s):  
Lynn McDonald ◽  
Stephe Billingham ◽  
Tammy Conrad ◽  
Arthur Morgan ◽  
O Nancy ◽  
...  

Families and Schools Together (FAST) is an early-intervention/prevention, collaborative, school-based, multifamily family-support program for elementary school children who have been identified by their teachers as having behavior problems. The program integrates concepts and practices of community organizing with effective clinical techniques based on family therapy and play therapy. Parent–professional partnership is used to engage low-income and isolated families into the eight-week program. Process and outcome evaluation indicate that children show statistically significant improvements in conduct disorder, anxiety/withdrawal, and attention span over time. In addition, two-year follow-up data suggest that child-functioning gains are maintained and that FAST parents become more involved at school, regularly see their FAST friends, begin employment after being on welfare, return for further education, and become involved in the community.


2020 ◽  
Vol 9 (9) ◽  
pp. 3023
Author(s):  
Youngjae Park ◽  
Yoon Jae Lee ◽  
Jung Hee Koh ◽  
Jennifer Lee ◽  
Hong-Ki Min ◽  
...  

Background: Stromal vascular fraction (SVF) has recently emerged as a potential therapeutic modality, due to its multipotent cellular components in tissue regeneration. Systemic sclerosis (SSc) is a progressive autoimmune disease that results in hand disability by skin fibrosis and microangiopathies. We performed an open-label study to investigate the efficacy and safety of SVF injection in SSc patients (Clinical Trial number: NCT03060551). Methods: We gathered 20 SSc patients with hand disability, planning for a 24-week follow-up period. SVF was extracted from autologous adipose tissues, processed by the closed system kit, and injected into each finger of SSc patients. We observed various efficacy and safety profiles at each follow-up visit. Results: Among the 20 initially enrolled patients, eighteen received SVF injection, and were completely followed-up for the whole study period. Patients received 3.61 × 106 mesenchymal stem cells into each finger on average. Skin fibrosis, hand edema, and quality of life were significantly improved, and 31.6% of active ulcers were healed at 24 weeks after injections. Semiquantitative results of nailfold capillary microscopy were ameliorated. There was no single serious adverse event related to the procedure. Conclusions: Injection of SVF derived from autologous adipose tissues is tolerable, and shows clinical efficacy in SSc patients.


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