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For well over a century, there have been boarding schools for American Indian children. The unique configuration that makes up each boarding school's environment attempts to meet the needs of as many students as possible, and tries to maximize positive outcomes. Recognizing that there is room for improvement, the Office of Indian Education Programs (OIEP) provided several years of funding to a group of schools in order to enhance their services to children. The selected boarding schools were provided Therapeutic Residential Model (TRM) funding to carry out their proposals. To determine each site's accomplishments as well as the efficacy of this approach, the OIEP concurrently implemented a cross-site evaluation. The evaluation was designed to: (1) provide a record and evaluation of the characteristics of each site's environment prior to funding; (2) document the course of planning and implementation of changes during TRM funding; (3) collect data on incoming students and outcome data agreed upon by all sites; (4) provide ongoing analysis of the data to the sites so that administrators could make program changes; and (5) use process and outcome data from these diverse sites to draw cross-site conclusions. In this article, the authors discuss the results of a cross-site evaluation which is patterned on chaos theory. Data were collected in the course of complex changes occurring in systems. Also, staff and student surveys provided the basis for data comparison among boarding schools. Furthermore, this article is divided into four sections including: (1) the identification of the factors that were common to sites that achieved high retention, and it describes the prevailing situation at those sites that were not successful at retaining students; (2) the examination of the process and outcome indicators that presumably impacted the retention rate at each TRM site; (3) the examination of each boarding school's ability to establish a data feedback loop to guide dynamic system change; and (4) is entitled Elephants in the Living Room, and deals with common issues across sites. The survey data indicated that students coming into the boarding school or peripheral dormitory sites had similar risk factors. (Contains 1 table and 24 figures.)

At the No Treatment Day School, less than 15% of students used the dormitory during the school week. Located in the heart of a reservation and serving local students, the K-12 school enrolled over 1,000 students. The site received Therapeutic Residential Model funding for the 2001-2002 school year. Initial evaluation of this site found an array of daunting problems throughout the school structure and functioning. There were some successes, including implementation of the Morningside reading program in the elementary school and some response from the community to the comprehensive evaluation report which provided an overview of the situation to policy-makers and community members. However instability in the system and a mid-year change in leadership complicated the process of implementation. By the end of the first year, it was clear that the feasibility of the original proposal was questionable and that an overhaul of he school's system and culture was necessary before a Therapeutic Residential Model could be implemented or significant change could come about. Therapeutic Residential Model funding was terminated at the end of the school year. As there was no substantial implementation of a Therapeutic Residential Model program, data gathered were utilized as representing a naturally occurring control or minimal treatment site. (Contains 8 tables and 16 figures.)

This off-reservation boarding school serves over 600 students in grades 4-12; approximately 85% of the students reside in campus dormitories. After having documented significant improvement on a number of outcomes during a previous High Risk Youth Prevention demonstration grant, the site submitted a Therapeutic Residential Model proposal, requesting funding to continue successful elements developed under the demonstration grant and to expand mental health services. The site received Therapeutic Residential Model funding for school year 2001-2002. Once funds were received, the site chose to shift Therapeutic Residential Model funds to an intensive academic enhancement effort. While not in compliance with the Therapeutic Residential Model initiative and therefore not funded in subsequent years, this site created the opportunity to enhance the research design by providing a naturally occurring placebo condition at a site with extensive cross-sectional data baselines that addressed issues related to current federal educational policies. (Contains 4 tables, 31 figures and 1 footnote.)

L3 is an intertribal residential school enrolling approximately 200 students in grades 5-8 from tribes in the northern Midwest. As a result of successful grant-writing which espoused Circle of Courage and Asset-Building, the school built up an impressive configuration of programs funded by a variety of sources, including a cadre of mental health professionals, and began increasingly to rely on their assessments and services. First funded by the Therapeutic Residential Model program in the 2002-2003 school year, L3 used the funding that year primarily to increase professional-level services of a psychiatrist and psychologist, and to maintain or expand programs which would otherwise have been terminated as funding from short-term sources was running out. Evaluation of this project began in January 2003, when the site was assessed and determined to be strongly oriented toward provision of Level Three, or professional-level, psychiatric and medical mental health services. The initial evaluation report identified a low retention rate and raised concerns that the presence of more than 200 staff on campus had resulted in a diffusion of responsibility, lack of consistency, and duplication or redundancy of services; that elements of the environment appeared to be detrimental to social development and emotional stability; and that an unusually high proportion of students were receiving psychiatric diagnoses and medication. The site was asked to address these issues, and additional funding was provided to bolster lower levels of triage by adding paraprofessional case managers to advocate or students and coordinate provision of services for them. Retention remained low at this site throughout the course of funding, and there were a high number of assaults and psychiatric hospitalizations compared with other sites. (Contains 14 tables and 11 figures.)

The purpose of the therapeutic model demonstration schools is: (1) to provide a program, based on an annual written plan, linking clinicians, counselors, and mental health professionals with academic program personnel in a culturally sensitive residential program tailored to the particular needs of Indian students; (2) to provide for a continued evaluation of the planning and implementation of the therapeutic model in the designated schools; and (3) to determine what steps the Bureau of Indian Affairs must take and what resources are required to transform existing off-reservation boarding schools to meet the needs of chemically dependent, emotionally disturbed, socially troubled or other at-risk Indian youth who attend such schools." The articles in this issue describe each of the sites which were funded during the Therapeutic Residential Model (TRM) initiative. The methodology used for the cross-site evaluation is described in this introductory article. The next five articles provide case studies of each site and vary in format and analysis of the data governed by environmental factors found at each site, the nature of problems identified and addressed by each system, and level of statistical power determined by sample sizes. Case studies of L1, L2, and L3, the sites funded for multiple years, include contributions from both the cross-site and internal site evaluations. The case study of Academic Enhancement (AE) is enhanced by data gathered in the course of a multiyear prevention demonstration project which had preceded TRM funding and had laid the groundwork for change at this site. The final article draws conclusions across sites, and discusses both best practices and barriers to success found in these sites. A Staff Survey is appended. (Contains 4 figures and 3 tables.)

This site is an intertribal residential grant school annually enrolling over 250 students in grades 1-8 from tribes located in three states on the Northern Great Plains. From its inception in 1890, the boarding school's mission has been to provide services for young children in need of a safe and supportive living and learning environment. For over a decade, this site has used strategies centered on respecting children, structuring students' time, and providing the therapeutic benefits of a well-maintained campus. This site also has a long history of believing in each child's inherent value and potential. When Therapeutic Residential Model funding commenced at the midpoint of the 2002-2003 school year, L1 focused these new resources on strengthening and refining its program. The number of personnel positions increased from 98 to 135, with new positions principally going to dormitory staff and four Masters-level counselor positions. This increase in staff allowed L1 to proactively address the children's developmental needs. The site also adopted and implemented the Applied Humanism caregiving model. In accordance with Applied Humanism, an interview was utilized that allowed the site to identify and hire applicants possessing the attitudes and skills necessary to be good caregivers, existing staff were trained so that they understood the kind of caregiving that would be expected of them, supervision procedures and practices were implemented that supported and encouraged good caregivers and provided time-limited assistance to those who were not, and relevant agency policies and procedures were revised as needed to align with the Applied Humanism philosophy. In addition, the Morningside program was brought in to systematically address the students' academic lags in reading. The results of implementing the Therapeutic Residential Model were a reduction in behavioral incidents, a decrease in the amount of money spent on external mental health services, an increase in the retention rate, an increase in academic skills in selected areas, and higher scores on pre-post measures of adjustment, interpersonal relationships, and adaptability. (Contains 16 tables and 19 figures.)

Three hundred and eight subjects were screened over the phone for admission to an inpatient alcohol treatment research unit. Using a structured interview, the prospective patients were asked questions regarding demographics, drinking history, previous treatments, physical health, family history, and a detailed history of past and present substance use. Drug use was studied as regular use versus no use or brief experimental use of five drug categories: cannabinoids, stimulants, sedatives, opiates, and hallucinogens. Fifty-one percent of the men and 48% of the women reported regular use of one or more of the drugs in addition to alcohol. For women, the amount of alcohol intake was positively correlated with use of stimulants (r = .32, p = .001), cannabinoids (r = .24, p = .019), sedatives (r = .30, p = .003), and hallucinogens (r = .30, p = .003). For men, correlations between the amount of alcohol intake and drug use were weaker but significant for stimulants (r = .21, p = .002), opiates (r = .15, p = .028), and hallucinogens (r = .15, p = .029). Women with alcoholic mothers displayed higher alcohol intake than women with nonalcoholic mothers (p = .02) and also showed more frequent use of most drugs. Although men with alcoholic fathers also showed greater alcohol intake compared to men with nonalcoholic fathers, the two groups did not differ in drug use. Younger subjects of both sexes were more likely to use cannabinoids, stimulants, opiates, and hallucinogens. Alcohol and sedative use was relatively constant across all age groups., INTRODUCTION Consumption of alcoholic beverages increased throughout the fifties, sixties, and seventies, but since 1981 an apparent downward trend has occurred[1]. Over the same period, usage patterns of other substances [...]

L3 is an intertribal residential school enrolling approximately 200 students in grades 5-8 from tribes in the northern Midwest. As a result of successful grant-writing which espoused Circle of Courage and Asset-Building, the school built up an impressive configuration of programs funded by a variety of sources, including a cadre of mental health professionals, and began increasingly to rely on their assessments and services. Firs funded by the Therapeutic Residential Model program in the 2002-2003 school year, L3 used the funding that year primarily to increase professional-level services of a psychiatrist and psychologist, and to maintain or expand programs which would otherwise have been terminated as funding from short-term sources was running out. Evaluation of this project began in January 2003, when the site was assessed and determined to be strongly oriented toward provision of Level Three, or professional-level, psychiatric and medical men al health services. The initial evaluation report identified a low retention rate and raised concerns that the presence of more than 200 staff on campus had resulted in a diffusion of responsibility, lack of consistency, and duplication or redundancy of services; that elements of the environment appeared to be detrimental to social development and emotional stability; and that an unusually high proportion of students were receiving psychiatric diagnoses and medication. The site was asked to address these issues, and additional funding was provided to bolster lower levels of triage by adding paraprofessional case managers to advocate or students and coordinate provision of services for them. Retention remained low at this site throughout the course of funding, and there were a high number of assaults and psychiatric hospitalizations compared with other sites. [ABSTRACT FROM AUTHOR]

The article highlights on a short form of the Interpersonal Style Inventory (ISI). The ISI was developed to access 15 major personality dimensions. The form also yields five higher-order factor scores, especially useful for profile interpretation. Because the ISI is composed of 300 items, it normally requires 40 to 50 minutes to complete. There are settings, however, in which the form is too long and takes too much time. It may be too long to add to a busy clinic's assessment battery, or to an experimental research project. For these reasons, an abbreviated form was designed that would require only 20 to 25 minutes of testing time, and yet, would provide useful estimates.

Alcohol has widespread effects on the γ-aminobutyric acid (GABA) system in the brain. This system in the brain is also postulated to have a role in anxiety, and alcoholics have been reported to have more anxiety disorders. Therefore, the authors undertook a study to compare CSF levels of GABA in abstinent alcoholic patients and normal control subjects. There was no significant difference between groups in CSF levels of GABA. Also, there was no significant difference in GABA level between alcoholic patients with histories of withdrawal seizures and those without such a history. [ABSTRACT FROM AUTHOR]

L2, one of the original sites first funded under the Therapeutic Residential Model Initiative in 2001-2002, is operated as a peripheral dormitory This dormitory cares for 185 boys and girls in grades 1 12 who attend local public schools. L2 presented an outstanding proposal which identified gaps in services and presented a reasonable budget to address those gaps by adding additional men al health services and increasing the number of residential and recreation staff With only minor modifications to this budget, the site efficiently and effectively implemented the strategies it had proposed and utilized evaluation feedback to fine-tune systems and maximize positive outcomes. The Therapeutic Residential Model funds enabled the site to move from a functional dormitory to a therapeutic residential situation where the needs of students are assessed and addressed. Outcome indicators in spring 2002, 2003, 2004, and 2005 showed impacts in a number of areas when compared with the baseline year of 2000-2001: • Retention of students steadily increased going from 40.7% in 2000-2001 to 68.4% in 2004-2005. • 75 students graduated from high school during the four Therapeutic Residential Model years, compared with 41 in the preceding four years. • Academic Proficiency and ACT scores improved significantly. • Thirty-day cigarette use dropped from 62% in spring 2001 to 38% in spring 2005 among 7th and 8th graders, from 58% to 33% among 9th and 10th graders, and from 72% to 29% among 11th and 12th graders. • Alienation indices showed an increase in feelings of inclusion and a decrease in lack of meaning. This site is an outstanding example of what can be done with a well-designed and responsibly implemented Therapeutic Model Program, and the measurable impacts which can result from such strategic use of resources. [ABSTRACT FROM AUTHOR]