Re: behavior modification "specialty programs" for "troubled teens"

["Bill Moore" <wmoore@xxxxxxxxxxxx>]

<x-flowed>
In agreement with Rick, I am markedly concerned about the type of 
interventions designed to treat "attachment disorders".  I viewed a website 
a foster mother asked me to investigate yesterday, that "guaranteed results" 
along with several former patient testimonials.  While neurologically-based 
terms are thrown around with professional name-dropping, there is no 
coherent underlying and comprehensive theoretical formation, with semantics 
such as "containment" instead of "holding".  I saw one 6 y/o girl regress 
over a period of "holding therapy", where oil was rubbed over her body as a 
form of "bonding".  She had been sexually abused in her history.

Parents, foster and otherwise, are sold on a miracle cure for children. 
They become quickly dichotomous in their thinking.  And often want someone 
else to pay for these elaborate schemes.  Alas, some conditions remain 
beyond our capacity to understand and alter, and remain immutable throughout 
the life span.

bill moore

----- Original Message ----- 
From: "Rick Barth" <rbarth@email.unc.edu>
To: "Child Maltreatment Researchers" 
<CHILD-MALTREATMENT-RESEARCH-L@cornell.edu>
Sent: Wednesday, October 13, 2004 10:01 AM
Subject: Re: behavior modification "specialty programs" for "troubled teens"


> Freya: Since I often read your posts with great interest, I want to thank 
> you for your many sterling contributions.  But, I must raise concern about 
> the conclusion that "attachment-based" therapies are more effective than 
> cognitive-behavioral treatments (I added the cognitive to your original 
> reference to behavior modification, because most such interventions are 
> now combined efforts, addressing information processing as well as social 
> learning).
>
> I have not seen the Fonagy and Roth works, but the single type of therapy 
> judged to be harmful in the review by Saunders, et al, was an "attachment 
> based therapy".
>
> Saunders, B. E., Berliner, L., & Hanson, R. F. E. (2003). Child physical 
> and sexual abuse: Guidelines for treatment (Final report: January 15, 
> 2003). Charleston, SC: National Crime Victims Research and Treatment 
> Center.
>
> Also,John Weisz, at UCLA, arguably the nation's leading scholar in the 
> area of child and adolescent interventions has long found--and continues 
> to find, in rigorous research syntheses that psychodynamic based 
> interventions--which would include atttachment based interventions--are 
> less effective than skill based interventions.  THis is an older 
> citation,but his more recent work is confirmatory.
>
> Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). 
> Effects of psychotherapy with children and adolescents revisited: A 
> meta-analysis of treatment outcome studies. /Psychological Bulletin, 117/, 
> 450-468.
>
> I know that your post was on a slightly different tack, but I wanted to 
> clarify that there is strong evidence that we should not be promoting the 
> effectiveness of attachment based therapies over other more evidence based 
> interventions.
>
> Rick
>
>
>
> F.Schultz@SBCSocialServ.org wrote:
>
>> This may not be entirely what you are looking for, but I would suggest 
>> you look at "What Works for Whom", a new summary of studies for evidence 
>> of efficacy for various forms  psychotherapy or psychological 
>> interventions by Fonagy and Roth.  Peter Fonagy is a research director 
>> for the Menninger Clinic and is a leading researcher on attachment theory 
>> and attachment-based interventions.  The book is divided into two 
>> sections, one for adults and one for children and adolescents.  I seem to 
>> recall that it finds lasting benefits for "attachment-based" therapies 
>> over behavior modification treatments.
>>  The book does not comment on the legal issues regarding behavior mod, 
>> just that it doesn't seem to have long-lasting beneficial results, 
>> whereas other therapies DO, depending on the issues presented by the 
>> child.
>>  It would seem to me that in any legal challenge to placement in a 
>> behavior mod program, efficacy of the intervention and whether the 
>> restrictions on the child are warranted in order to insure a lasting 
>> beneficial outcome would be an issue.
>>  I looked at the web site you cited as your "agency" and did not find 
>> anything that tells me anything about the group or agency you may 
>> represent.
>>  Freya Schultz
>> Santa Barbara County Social Services
>>
>> ------------------------------------------------------------------------
>> *From:* owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu 
>> [mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu] *On Behalf Of 
>> *Elisabeth Feldman
>> *Sent:* Tuesday, October 12, 2004 8:32 AM
>> *To:* Child Maltreatment Researchers
>> *Subject:* behavior modification "specialty programs" for "troubled 
>> teens"
>>
>> Is anyone aware of outcome studies on private/nonadjudicated behavior 
>> modification based "specialty" wilderness, boarding school and/or 
>> residential treatment centers for "troubled" teens?
>>  Is there anyone out there who is or knows of someone researching this 
>> topic from the perspective of parental vs. minors rights (as most of 
>> these programs deny constitutional rights of minors in favor of parental 
>> rights, i.e. minors in these facilities have no right to contact an 
>> attorney, sometimes no right to contact anyone except parents, and even 
>> then, contact is monitored.)
>>  Thank You,
>>  Elisabeth Feldman
>> The Troubled "Troubled" Teen Industry Research Group 
>> <http://www.troubledteenindustry.blogspot.com>
>
> 

</x-flowed>