Behavioral Approaches to Behavioral Approaches to Residential TreatmentResidential Treatment

Joseph H Evans, PhDJoseph H Evans, PhD

Munroe-Meyer InstituteMunroe-Meyer Institute

University of Nebraska Medical Center University of Nebraska Medical Center

Deinstitutionalization Movement – Deinstitutionalization Movement – Late 1960’sLate 1960’s

Reaction to Institutional Abuses inReaction to Institutional Abuses in

State “Mental Hospitals”State “Mental Hospitals”

State “Homes for the Mentally Retarded”State “Homes for the Mentally Retarded”

Juvenile Offender “Industrial Schools”Juvenile Offender “Industrial Schools”

To a lesser degree, State “Prisons”To a lesser degree, State “Prisons”

Common Institutional ProblemsCommon Institutional Problems

Long, often unnecessary, staysLong, often unnecessary, stays Programs designed for staff (not client treatment) Programs designed for staff (not client treatment)

convenienceconvenience Poor staffing ratiosPoor staffing ratios Poorly trained staffPoorly trained staff ““Therapy” provided hour(s) per weekTherapy” provided hour(s) per week Physical and emotional abuses of clientelePhysical and emotional abuses of clientele Removal of contacts with family and communityRemoval of contacts with family and community Little or no objective criteria for release Little or no objective criteria for release

Landmark Legal Cases Against Landmark Legal Cases Against InstitutionsInstitutions

Pennsylvania - PennhurstPennsylvania - Pennhurst

New York - New York -

Alabama - Alabama -

Nebraska – Horacek vs ExonNebraska – Horacek vs Exon

Behavioral Attempts to Improve Behavioral Attempts to Improve Residential Care Residential Care

Anna State Hospital- IL (Ayllon and Azrin)Anna State Hospital- IL (Ayllon and Azrin)

Camarillo State Hospital- CA (Lieberman)Camarillo State Hospital- CA (Lieberman)

Sunland Centers – FL (Pennypacker)Sunland Centers – FL (Pennypacker)

Teaching Family ProjectTeaching Family Project

Residential Behavioral Program for Children Residential Behavioral Program for Children and Adolescents in the Communityand Adolescents in the Community

Developed at the University of Kansas - Developed at the University of Kansas -

Dept of Human Development and Family LifeDept of Human Development and Family Life Developed in Response to Local Needs in Developed in Response to Local Needs in

Lawrence, KansasLawrence, Kansas Funded by National Institute for Mental HealthFunded by National Institute for Mental Health Adopted by Boys Town - 1975Adopted by Boys Town - 1975

Goals of the Teaching Family Goals of the Teaching Family Project: A Program that is:Project: A Program that is:

Community-BasedCommunity-Based Cost-EfficientCost-Efficient ResearchedResearched Replicable Replicable Satisfying to ConsumersSatisfying to Consumers