Parents’ experience and successful adjustments after the return of the child from a long-term stay at a residential treatment center
Literature Review
When a child is admitted to a residential treatment center (RTC), the parent retains the rights and responsibilities of care regarding that child in all life issues (Hopkins, Kamins, Happ, & Hunt, 2008). Children below the age of 17 are under the protection of their parents especially in issues regarding decision making and approvals (Children's, 2009). However, once the children meet the legal age of adulthood at 18 years and above, they may have rights to restrict the release of some information to their parents. As an adult, the patient harbors the right to make decisions inclusive of demanding release from a residential mental facility. However, mental health workers have the opportunity to educate parents on handling such issues that demand parental assistance. For instance, parents can obtain court orders to overrule the decisions of their children in respect to disabilities (Children's, 2009). Such a court order provides a parent the opportunity to extend parental guidance towards the child’s wellbeing. Hirsch (2009) discovered that there were varying outcomes from patients discharged from RTC. While some empirical studies show that young adults are able to show long-term success in managing their mental problems, others inform about the difficulties associated to maintenance of the mental health improvement (Hopkins et al. 2008). In this respect, the research points out that although past literature discusses the positive effects linked to long term success, there are confusions about the risks that patients may pass through when adjusting to the long-term success. Hirsch’s research evaluated these risks and protective elements that control the effectiveness of success after discharge. The research postulated that individuals who have retained stable mental health conditions after 6-12 month had accessed health services or used other services inclusive of medical aid and avoidance of drug abuse to maintain their state. They also associated the successful treatments to positive peer interaction and prevention of negative influences. The research found that the young adults depicting success within the intervals either had all/some of the features mentioned in the hypothesis. This research shed more light in the lifestyles of adolescents after discharge from RTC showing the roles and need of parental involvement in mentoring their children. Mental health workers have the responsibilities of ensuring follow-up programs in order to enhance proper treatment for the patients.
The main function of RTC is to take care of patients in order to stabilize their mental conditions before returning them to parents. Perceptually, the return of these children has stress and disruption challenges that affect the establishment of effective transition after discharge (Children's, 2009). Mental health workers have a mandate to ensure that patients have decisive connection to their family in order to boost the transition after discharge. This connection is facilitated by support, enhancements, and maintenance of family relations throughout the residential treatment (Simon & Savina, 2010). However, since the policies placed on RTC limits the establishment of a frequent connection between parents and their children, mental health workers must guide and subject parents to reliable transition procedures after discharge (Hopkins et al. 2008). The transition after patient discharge from TRC is based on a divergent theoretical framework. The role of parents does not only apply as a subject of discussion within the therapies of patients, but also the physical presence and participation of the parents (Preyde, Adams, Cameron, & Frensch, 2009). Parents and the mental care workers are partners in fostering the proposed changes in the young adults. The RTC staff struggles to change the perception that parents connecting to the RTC program may not understand the plans and programs being followed during treatment periods. Essentially, the mental health workers work together with the parents to accomplish a course of transition after discharge. This dictates that the transitioning period is another critical part of the treatment offered by the RTC but administered by the parents. The workers must collaborate with the parents in order to select and apply the most effective support for improvements after the young adult is exposed to less restrictive environments (Simon & Savina, 2010). Parents are affected emotional and mentally when their child has a severe mental instability. The success of residential program becomes fortune of their handwork. However, research postulates that most parents retain fears that their child may be subject to the same problem in the future. Parental support is, therefore, critical to retain an effective assistive program with specialists (Simon & Savina, 2010). Some facilities create training programs where they encourage and motivate the parents to undertake activities that boost their courage when assisting patent transitioning. Essentially, the parent has the opportunity to suggest a transitioning program for the child in order to facilitate communication and understand the possible aspects of transitioning as well as their effectiveness (Hopkins et al. 2008). In this respect, the worker views such a parent as a partner in impacting change and treatment to the child. In essence, if the child does not gain the mental improvements after discharge, the work done during the residential treatment becomes obsolete and unreliable. The workers must connect the parents with community services of people facing similar issues in order to facilitate sharing of ideas and create accessible platforms where such people can be brought together for education.
Methodology
The construction of specific procedures that should be followed when addressing the research question is essential in order to enhance goal achievement and reliable outcomes towards the end of the investigations. The researcher’s methodology will consist of a collective qualitative case study of 10 to 14 participants following Yin’s (2009) model. Using random purposeful sampling, the research will conduct interviews with the participants in order to understand the perspective of the mental health workers on parents of the patients. In a bid to accomplish this task, the researcher will meet with the Director of Continuum of Care to inform him or her about the study and its participation in filling a gap in nursing knowledge in order to get permissions of meeting clinicians who treated the young adults adjusting positively while transitioning at home. If such permissions are not given, the consent of other RTC will be sought in order to make the investigation. Essentially, since most RTC have issues proving the credibility of the facilities, it may be expected that the managements may restrict the investigation in their center. However, other institutions may accept to take part in the research investigation. It is, therefore, prudent to create concise explanations regarding the aims of the research and the advantage associated to it before meeting the managers. The issuance of organizational permission will open the access to individual consent for workers’ participation. Essentially, the participation will be confirmed using a consent form detailing the components of the research activity before selecting 10-14 participants from a large group of clinicians. Essentially, the workers to be interviewed must sign the consent form and submit it to a specific location or the researcher will collect the forms in order to isolate the individual who agreed to the request for participation with others. The participating clinicians must have reported satisfactory reintegration through positive adjustments of the child between 17 to 20 years of age. These clinicians will share their understanding on the parents who managed to have successful outcomes from their mental problems.
The data collection will commence by formulating 10 open-ended questions that can be used to evaluate the mental health workers views on the parents. After selecting these questions that address the research objective, a schedule and clinician commitment plan to this research will be established by visiting each practitioner at the place of work. Considering that the clinicians are located within the same treatment center or it branches, the information may take 2 to three days in order to collect all the data when allowing the practitioners sufficient time to make responses. Primarily, open ended question give interviewees the opportunity to provide a broad spectrum about the issues they would like to comment about. In principle, it is crucial to seek the consent of the interviewee in order to record interviews and keep record for reference when analyzing it. Audio or video record would allow the interview to use minimum time while making note and seeking clarifications since such clarity is present in the records. However, such interview data and records must be kept confidential in order to prevent assure the participant about their research safety after giving information in the future studies. Furthermore, the research should take notes about the points being delivered by the participants. The interview will reveal the feelings of parents and their commitments in enabling successful treatment and transitioning after their young adult left RTC. Essentially, this bit of information will be accompanied by the challenges and adjustment problems faced by the parents after discharge from the mental facility. In this respect, the question will target to seek information regarding the perspectives of the practitioners on parental behaviors that affected children recovery and boosted family connection during and after discharge. Furthermore, the staff will inform about the participation of parents in impacting changes and influencing the decision of the adult. The cases described by the practitioners will be analyzed deeply to understand the challenges that these parents meet as well as the approach they use to develop the perceived success in adjusting to their normal lives. The interviews will be analyzed and coded by using the case study approach to conduct an embedded analysis of each interview. A cross-case analysis will be implemented to analyze the commonalities and difference of each participant’s challenges and experiences with the adjustment experiences. This data analysis model will compare and contrast data presented by the practitioners in order to make decisive conclusions based on the 10 interviews. From these analyses, the discussion and conclusions will be constructed depending on the majority arguments presented by the practitioners handling the patients.
References
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Hirsch, M., B. (2009). A Study of Long-term Outcomes of Adolescents Discharged from a Local Residential Treatment Center: Factors Responsible for Treatment Gain Maintenance (Doctoral dissertation, Pacific University). Retrieved from: http://commons.pacificu.edu/spp/78
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