Matching Dimensions of Organizational Functioning6 with Environmental Adherence (EA) Items
| Dimensiona | Definition | Subscales | Example Items | EA Youth Items | EA Staff Items |
|---|---|---|---|---|---|
| Institutional orderb | Set schedules, clear lines of responsibility, and cohesion among staff about shared mission. Clear rules and routines; consistency of messages provided by staff about normative values; positive modeling and connection between staff members and residents | Overall organization | We follow a regular schedule every day. | Item 6. Did staff explain to you how to earn privileges? Item 7. Do you know what structure/activities to expect on a daily basis? Item 8. Do staff lead activities in the program? | Item 5. Program is structured in a way that ensures treatment is occurring Item 6. Youth have structured programming on the floor (behavior permitting) Item 7. Important treatment specific information is communicated among staff daily |
| Staff connectedness | Staff worked with kids who were failing. | Item 1. Does the staff’s voice remain firm and supportive when a youth is not following directions? | Item 1. Staff are respectful in their communication with youth Item 9. Staff structures milieu to actively engage youth in generalizing skills Item 10. There is a clear programmatic structure that pairs privilege to treatment performance | ||
| Staff negative behavior | How much do you see staff using disrespectful language? | None | None | ||
| Caring adults | Concerned connection between staff members and residents; Positive relationships with caring adults; Social support provided by key staff members | Social support: Domains | Is there an adult here with whom you can talk about important decisions in your life? | Item 2. Would you describe staff as “excited to work with youth” during interactions? Item 3. Are staff working with you to accomplish your treatment goals? Item 4. Do staff assist you in resolving treatment concerns you may have? | Item 2. Staff convey genuine regard and liking toward youth Item 3. Staff demonstrate that they listen to youth Item 4. Behavior is described in an empathetic, objective and nonjudgmental way Item 11. Staff help youth accomplish treatment goals that are important to the youth |
| Social support:Diversity | How many different adults can you talk to about important decisions? | None | None | ||
| Reentry planningb | Gains made during institutional stays may deteriorate unless reinforced or built on in the community; Institutions provide focused resources to assist in the community transition | Future orientation of the program | Staff help individuals here get jobs. | Item 10. Do staff work with you on how to apply your skills to your community/home setting? | None |
| Release counselor | Did you have a person assigned to you to help you out with making arrangements for you to return to the community? | None | None | ||
| Treatment milieuc | Staff members coach youth on emotional and behavioral skills and reinforces use of these skills in the milieu | Not applicable | Not applicable | Item 5. Are you practicing new skills to earn reinforcements (token incentives) from staff? Item 9. Do staff help coach you on how to use your skills? | Item 8. Program effectively reinforces behaviors Item 12. Staff apply DBT strategies in the milieu Item 13. Staff support each other in delivering the treatment with fidelity |
↵a Mulvey6 included eight selected dimensions of organization functioning, including safety; institutional order; harshness; caring adults; fairness; antisocial peers; services; and reentry planning. Dimensions included here are based on availability of EA items that are conceptually similar and align with Mulvey’s definitions and example items.
↵b Institutional order, harshness, level of service provision, and release planning distinguished the most among different institutions in Mulvey et al.6 Intraclass correlations are examined for the subscales.
↵c Extends Mulvey’s findings with the addition of a new “treatment milieu” dimension.