title: Severely disturbed adolescents in community care.
abstract: The purpose of this research was to study key concepts related to deinstitutionalization and community facilities for emotionally disturbed adolescents. This study was conducted in two phases: In Phase I, a statewide survey was mailed to all licensed group-care providers; in Phase II, field research methods were used to collect data on five small residential facilities, each serving between four and sixteen residents. An average of 35 hours was spent observing in each facility and a total of 53 interviews were conducted with staff, residents, and administrators. Survey results indicate that a total of 125 licensed group-care agencies in Massachusetts serve 4081 residents of all ages and disabilities in residential programs. At least sixty of these facilities accept adolescents, and seventy-four of them have state approval as residential schools for youngsters with special educational needs. Findings from the field research phase indicate that small group-care facilities place an emphasis on treatment and therapeutic intervention. The therapeutic activities in five facilities share similar features, and a classification scheme based on these similarities is offered. Other findings indicate that small residential facilities are not necessarily community-based, and that living in a small facility does not ensure integration into the community. A four-point scale is presented to measure the range of possible community-oriented activities. Four origins of decision-making about community activities are noted. Other findings indicate that the facilities are characterized by a high degree of staff/resident interaction, and that they possess some characteristics of total institutions, mediatory institutions, and families; the results suggest that these facilities are a new type of social setting with no direct correlation to other types of institutions.
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000523:psychology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003156:Community Mental Health Services; D003688:Deinstitutionalization; D004519:Education, Special; D006208:Halfway Houses; D006801:Humans; D008404:Massachusetts; D010348:Patient Care Team; D011369:Professional-Patient Relations; D012114:Residential Treatment; D012917:Social Adjustment; D012931:Social Environment