Cibiyar Kula da Yanayi

Cibiyar kula da gidaje (RTC), Wani lokacin ana kiranta farfadowa, cibiyar kula da lafiya ce mai rai wanda ke ba da magani ga cututtukan amfani da kwayoyi, Rashin lafiya na hankali, ko wasu matsalolin halayyar. Ana iya la'akari da maganin zama a matsayin hanyar "ƙarshe" don magance ilimin halayyar mutum ko ilimin halayya.

Shirin kula da zama ya ƙunshi kowane shirin zama wanda ke kula da batun halayyar mutum, gami da cututtukan halayyar dan adam kamar cututtukani na cin abinci (misali sansanin asarar nauyi) ko rashin horo (misali, sansanonin motsa jiki a matsayin sa hannun rayuwa). Wani lokaci wuraren zama suna ba da damar samun damar samun albarkatun magani, ba tare da waɗanda ke neman magani ba waɗanda ake la'akari da mazauna shirin magani, kamar wuraren kiwon lafiya na Gabashin Turai. Amfani mai rikitarwa na shirye-shiryen zama don gyaran halayyar da al'adu sun haɗa da maganin juyawa da makarantun zama na Amurka da Kanada don 'yan asalin ƙasar. Wani fasalin yau da kullun na shirye-shiryen zama shine sarrafa damar zamantakewa ga mutanen da ke waje da shirin, da kuma iyakance damar ga bangarorin waje don shaida yanayin yau da kullun a cikin shirin. A cikin ilimin halayyar dan adam, an fahimci cewa kusan ba zai yiwu a canza halayyar da aka kafa ba tare da yin tasiri ga dangantakar al'ada ba, aƙalla a cikin ɗan gajeren lokaci, amma yanayin rufewar shirye-shiryen zama da yawa yana ba da damar ɓoye ayyukan zamba.

Bayan fitarwa, mai haƙuri na iya shiga cikin shirin mai zurfi na waje don bin diddigin waje a waje da wurin zama.

 Tarihin tarihi a Amurka 
A cikin 1600s, Biritaniya ta kafa Dokar Talakawa wacce ta ba da damar horar da yara matalauta a cikin koyo ta hanyar cire su daga iyalansu da tilasta musu su zauna a gidajen rukuni. A cikin 1800s, Amurka ta kwafe wannan tsarin, amma sau da yawa ana sanya yara marasa lafiya a kurkuku tare da manya saboda al'umma ba ta san abin da za ta yi da su ba. Babu RTCs a wurin don samar da kulawa ta awa 24 da suke bukata, kuma an sanya su a kurkuku lokacin da ba za su iya zama a gida ba. A cikin shekarun 1900, Anna Freud da takwarorinta sun kasance wani ɓangare na Vienna Psychoanalytic Society, kuma sun yi aiki a kan yadda za a kula da yara. Sun yi aiki don ƙirƙirar cibiyoyin kula da gidaje ga yara da matasa da ke fama da rikice-rikice na motsin rai da halayyar mutum.

Shekarar 1944 ta nuna farkon aikin Bruno Bettelheim na Makarantar Orthogenic a Birnin Chicago, da kuma aikin Fritz Redl da David Wineman a gidan Pioneer a Detroit. Bettelheim ya taimaka wajen wayar da kan jama'a game da halayen ma'aikata game da yara a cikin magani. Ya karfafa ra'ayin cewa asibitin mahaukaci al'umma ce, inda ma'aikata da marasa lafiya suka rinjayi juna kuma marasa lafiya sun tsara su ta hanyar halayen juna. Bettelheim ya kuma yi imanin cewa iyalai bai kamata su kasance da hulɗa da ɗansu ba yayin da yake cikin magani. Wannan ya bambanta da maganin al'umma da maganin iyali na 'yan shekarun nan, wanda burin magani shine yaro ya kasance a cikin gida. Har ila yau, ana mai da hankali kan rawar da iyali ke takawa wajen inganta sakamako na dogon lokaci bayan magani a cikin RTC. Gidan Pioneer ya kirkiro wani shirin ilimi na musamman don taimakawa wajen inganta kula da motsin rai da zamantakewa a cikin yara. Bayan WWII, Bettelheim da hadin gwiwar Redl da Wineman sun taimaka wajen kafa wuraren zama a matsayin madadin magani ga yara da matasa waɗanda ba za su iya zama a gida ba 

A cikin shekarun 1960, an kirkiro ƙarni na biyu na RTC na psychoanalytical. Wadannan shirye-shiryen sun ci gaba da aikin Vienna Psychoanalytic Society don haɗawa da iyalai da al'ummomi a cikin maganin yaro. Ɗaya daga cikin misalai na wannan shine Walker Home da School wanda Dr. Albert Treischman ya kafa a cikin 1961 don yara maza masu matasan da ke da mummunar motsin rai ko halayyar. Ya haɗa da iyalai don taimaka musu wajen haɓaka dangantaka da yaransu a cikin gidaje, makarantun jama'a da al'ummomi. Haɗin iyali da al'umma ya sa wannan shirin ya bambanta da shirye-shiryen da suka gabata.

Da farko a cikin shekarun 1980s, ana amfani da maganin halayyar fahimta a cikin ilimin halayyar yara,  matsayin tushen shiga tsakani ga matasa masu wahala, kuma an yi amfani da shi a cikin RTCs don samar da sakamako mafi kyau na dogon lokaci. Ka'idar haɗi kuma ta samo asali ne don mayar da martani ga hauhawar yara da aka shigar da su cikin RTCs waɗanda aka yi wa zalunci ko watsi da su. Wadannan yara suna buƙatar kulawa ta musamman daga masu kulawa waɗanda ke da masaniya game da rauni.

A cikin shekarun 1990s, yawan yara da ke shiga RTCs ya karu sosai, wanda ya haifar da sauya manufofi daga ayyukan da suka danganci ma'aikata zuwa tsarin kula da al'umma na iyali.Susan Yelton, Children in residential treatment — Policies for the '90s, Children and Youth Services Review, Volume 15, Issue 3, 1993, Pages 173-193, ISSN 0190-7409, 10.1016/0190-7409(93)90002-Q. Wannan kuma ya nuna rashin albarkatun magani masu dacewa. Koyaya, cibiyoyin kula da gidaje sun ci gaba da girma kuma a yau suna da yara sama da 50,000.Latest Findings in Children's Mental Health, Nearly 66,000 Youth Live in U.S, Mental Health Programs, Vo1. 2, No.  1 (Summer 2003).  In 1997, the year in which the most recent data was available, over 42,000 children were living in RTCs.  Given the growth of children living in RTCs, see supra note 2, this figure is likely well over 50,000 now. Adadin cibiyoyin kula da gidaje a Amurka a halin yanzu an kiyasta su a wurare 28,900.

 Yara da matasa 
RTCs ga matasa, wani lokacin ana kiransu cibiyoyin farfadowa na matasa, suna ba da magani ga batutuwa da rikice-rikice irin su rikice-rikicen adawa, rikice-rubuce na halin kirki, baƙin ciki, rikicewar bipolar, rikice na Rashin kulawa (ADHD), batutuwan ilimi, wasu rikice-war mutum, da batutuwan lokaci na rayuwa, da kuma rikice-tashen amfani da kwayoyi. Yawancin suna amfani da tsarin gyaran halayyar. Sauran suna da alaƙa. Wasu suna amfani da al'umma ko ingantaccen al'adun al'adu. Shirye-shiryen gama gari yawanci suna da girma (masu cin gashin kansu 80 da kuma kusan 250) kuma suna mai da hankali kan tsarin maganin su. Wato, don sarrafa halayyar abokan ciniki, galibi suna sanya tsarin lada da azabtarwa a wuri. Shirye-shiryen kwararru yawanci karami ne (kasa da abokan ciniki 100 kuma kaɗan kamar 10 ko 12). Shirye-shiryen kwararru yawanci ba su mai da hankali kan gyaran halayyar kamar yadda shirye-shiryen gaba ɗaya suke.

RTCs daban-daban suna aiki tare da nau'ikan matsaloli daban-daban, kuma tsarin da hanyoyin RTCs sun bambanta. Wasu RTCs wuraren kulle ne; wato, an kulle mazauna a cikin ɗakin. A cikin wurin kula da gida da aka kulle, an ƙuntata motsi na abokan ciniki. Idan aka kwatanta, wurin kula da gida da ba a kulle ba su damar motsawa a kan wurin tare da 'yanci na dangi, amma ana ba su izinin barin wurin ne kawai a ƙarƙashin takamaiman yanayi. Bai kamata a rikita cibiyoyin kula da gidaje da Shirye-shiryen ilimi na zama ba, wanda ke ba da madadin yanayi ga yara masu haɗari su zauna da kuma koyo tare a waje da gidajensu.

Cibiyoyin kula da yara da matasa suna kula da yanayi da yawa daga jaraba miyagun ƙwayoyi da barasa zuwa cututtukan motsin rai da na jiki da kuma cututtukani na hankali. Nazarin daban-daban na matasa a cibiyoyin kula da gidaje sun gano cewa mutane da yawa suna da tarihin batutuwan da suka shafi iyali, galibi sun haɗa da cin zarafin jiki ko jima'i. Wasu wurare suna magance cututtuka na musamman, kamar su cututtukan haɗi (RAD).

Cibiyoyin kula da gidaje galibi suna mai da hankali kan asibiti kuma da farko suna ba da kula da halayyar da magani ga matasa da ke da matsaloli masu tsanani. Sabanin haka, makarantun kwana na warkewa suna ba da magani da ilimi a cikin makarantar kwana ta zama, suna amfani da ma'aikatan ma'aikatan zamantakewa, masu ilimin halayyar dan adam, da likitocin kwakwalwa don yin aiki tare da ɗalibai a kowace rana. Wannan nau'in magani yana da burin samun nasarar ilimi da kuma kwanciyar hankali na jiki da tunani a cikin yara, matasa, da matasa. Abubuwan da ke faruwa a baya-bayan nan sun tabbatar da cewa wuraren kula da gidaje suna da ƙarin bayani daga masu ilimin halayyar mutum don inganta sakamakon da rage ayyukan rashin ɗabi'a.

 Halin halayyar mutum 
Halin halayyar ya taimaka sosai wajen rage halayen matsala a cibiyoyin kula da gidaje. Irin abokan ciniki da ke karɓar ayyuka a cikin kayan aiki (yara da ke da rikice-rikice na motsin rai ko halayyar da ke da nakasa ta hankali da rikicewar hankali) wani abu ne na tasirin gyaran halayyar. An gano cewa shiga tsakani na halayyar yana da nasara ko da lokacin da maganin ya kasa.Luiselli, J.K. &  Evans, T.P. (1987) Koyaya, akwai shaidar cewa wasu al'ummomi na iya amfana da yawa daga tsoma baki da suka fada waje da tsarin canjin halayyar. Misali, an bayar da rahoton sakamako mai kyau don shiga tsakani na neurosequential wanda ke da alaƙa da batutuwan rauni da haɗin kai na yara.  (Perry, 2006). Perry, B.D. (2006) The Neurosequential Model of Therapeutics: Applying principles of neuroscience to clinical work with traumatized and maltreated children.  In N. B.  Webb (Ed.),  Working with traumatized youth in child welfare (pp. 27-52). New York: The Guilford Press. Kodayake yawancin yara da ke karɓar ayyuka a cikin RTCs suna gabatar da rikice-rikice na motsin rai da halayyar halayyar (EBDs), irin su rikicewar Rashin kulawa (ADHD), rikicewar adawa (ODD), da rikicewar halayyar hali (CD), dabarun gyaran halayyar na iya zama hanya mai tasiri don rage halayyar waɗannan abokan ciniki. Za'a iya amfani da tsoma baki kamar farashin amsawa, Tattalin arzikin alama, kungiyoyin horar da ƙwarewar zamantakewa, da kuma amfani da ingantaccen ƙarfafa zamantakewa don kara halayyar zamantakewa a cikin yara (Ormrod, 2009). Ormrod, J.E. (2009). Essentials of Educational Psychology (2nd ed.). Upper Saddle River, NJ: Merrill.

Halin halayyar yana da nasara wajen kula da yara da ke fama da rikice-rikice na halayyar a wani bangare saboda sun haɗa da ka'idoji guda biyu waɗanda suka zama ainihin yadda yara ke koyo: fahimtar ra'ayi da gina kan ilimin da suka riga sun kasance. Binciken da Resnick ya yi (1989)  ya nuna cewa har ma da jarirai suna iya haɓaka tsarin ƙididdiga na asali. Ana shigar da sabbin bayanai a cikin tsarin kuma yana aiki a matsayin tushen ƙwarewar warware matsalar da yaro ke tasowa yayin da ta fallasa shi ga nau'ikan motsawa daban-daban (misali, sababbin yanayi, mutane, ko mahalli). Kwarewa da yanayin da yaro ya fuskanta na iya samun sakamako mai kyau ko mara kyau, wanda, bi da bi, yana tasiri ga yadda yake tunawa, dalilai, da daidaitawa yayin fuskantar abubuwan da ba su da kyau. Bugu da ƙari, lokacin da yara suka sami ilimi mai yawa, yana shafar abin da suka lura da kuma yadda suke tsarawa, wakilci, da fassara bayanai a cikin yanayin su na yanzu (Bransford, Brown, & Cocking, 2000). Bransford, J.D., Brown, A.L., & Cocking, R.R. (2000). How People Learn: Brain, Mind, Experience, and School. Washington, DC: National Academy Press. Yawancin yaran da ke cikin RTCs an fallasa su ga mummunan abubuwan muhalli waɗanda suka ba da gudummawa ga matsalolin halayyar da suke nunawa.

Yawancin tsoma baki suna gina kan ilimin yara na baya game da yadda lada ke aiki. Karfafa yara don halayen zamantakewa (watau, amfani da tattalin arzikin alama, inda yara ke samun alamomi don halayen da suka dace; farashin amsawa (rashin alamomin da aka samu a baya bayan halayyar da ba ta dace ba; da aiwatar da kungiyoyin horar da ƙwarewar zamantakewa, inda mahalarta ke lura da shiga cikin tsara halayen zamantakewar da suka dace ya taimaka musu su haɓaka zurfin fahimtar sakamako mai kyau na halayyar zamantakewa.

Wolfe, Dattilo, & Gast (2003)  sun gano cewa yin amfani da tattalin arziki na alama tare da wasannin hadin gwiwa ya kara halayen zamantakewa (misali maganganun ƙarfafawa, yabo, ko godiya, girgiza hannu, da ba da manyan biyar) yayin da yake rage masu adawa da zamantakewa (sweering, barazanar takwarorinsu da lahani na jiki, kira, da tashin hankali na jiki). Amfani da tsarin amsawa-farashin ya kasance mai inganci wajen rage halayen matsala. An yi amfani da ƙirar janyewa guda ɗaya da ke amfani da ƙarfafawa ba tare da biyan kuɗi ba don rage halayen magana da na jiki da ɗaliban bayan cibiyar da ke da ADHD (Nolan & Filter, 2012).  Wilhite & Bullock (2012)  sun aiwatar da ƙungiyar horar da ƙwarewar zamantakewa don haɓaka ƙwarewar jama'a na ɗalibai tare da EBDs. Sakamakon ya nuna bambance-bambance masu mahimmanci tsakanin gabatarwar horo kafin da bayan shiga tsakani, da kuma wasu abubuwa da yawa na ma'auni na halayyar halayyar. Har ila yau, akwai shaidu don amfanin ƙarfafa zamantakewa a matsayin wani ɓangare na tsoma baki na halayyar yara masu cutar ADHD. Binciken da Kohls, Herpertz-Dahlmann, & Kerstin (2009)  ya gano cewa duka lada na zamantakewa da na kudi sun kara karfin iko a cikin kungiyoyin sarrafawa da gwaji. Koyaya, sakamakon ya nuna cewa yara da ke da ADHD sun amfana da ƙarfafa zamantakewa fiye da yara na yau da kullun, yana nuna cewa ƙarfafa zamantakewa na iya inganta kulawar fahimta a cikin yara na ADHD. Hanyoyin da aka lissafa sune kawai 'yan nau'ikan sa hannun halayyar da za a iya amfani da su don kula da yara tare da EBDs. Ana iya samun ƙarin bayani game da nau'ikan sa hannun halayyar a cikin littafin 2003 Behavioral, Social, and Emotional Assessment of Children and Adolescents by Kenneth Merrell .

Nau'o'in Magungunan Iyali da aka yi amfani da su a Cibiyar Kula da Gida

Magungunan Labari: Magungunan Magungunan Bayani sun nuna karuwar shahara a fagen maganin iyali. Magungunan labaran da aka samo asali ne daga ra'ayi na zamani, wanda aka bayyana a cikin ka'idodinsa: (a) babu gaskiyar duniya guda ɗaya, amma gaskiyar da aka gina ta hanyar zamantakewa; (b) gaskiyar ta halitta ta hanyar harshe; (c) labarin yana riƙe da gaskiyar (d) ba duk labaran daidai ba ne  (Freedman da Combs, 1996).

Maganin iyali na ba da labari yana kallon batutuwan ɗan adam daga waɗancan tushen kamar yadda suke fitowa kuma ana ci gaba da su ta hanyar manyan labarun da ke sarrafa rayuwar mutum. Matsaloli suna tasowa lokacin da labaran mutum ba su dace da kwarewar rayuwarsu ba. Dangane da ra'ayi na labarin, ta hanyar ba da sabon ra'ayi mai banbanci 

A cikin labarin da ke cike da matsala, magani tsari ne na sake rubuta labaran mutum. Tsarin sake rubuta labarin abokin ciniki ya haɗa da (a) bayyana matsalar (s) da suke fuskanta; (b) rushe labaran da ke haifar da matsaloli ta hanyar tambaya; (c) gane sakamako na musamman ko lokutan da mutum bai tilasta masa ta halin da yake ciki ba; (d) haɗa takamaiman sakamako zuwa nan gaba da samar da labarin da ake so; (e) gayyatar da al'umma don kallon sabon labarin da (f) yin rajista sabbin ra'ayoyi ne maimakon hanyoyin da suka gabata. Koyaya, wasu masu bincike sun bayyana dabarun da ke da amfani wajen taimakawa mutum ya sake rubuta takamaiman kwarewa, kamar sake ba da labarai da rubuta wasiƙu.

Yara da aka shigar da su a cibiyar kula da gida suna da matsalolin halayyar da suka yi tsananin cewa maganin zama shine begen su na ƙarshe. Iyaye suna tunanin yaron shine matsalar da ake buƙata don gyarawa, kuma komai zai yi kyau; a gefe guda, yaron gabaɗaya yana ganin kansu a matsayin wanda aka azabtar. Magungunan ba da labari suna ba da damar rushe waɗannan ra'ayoyin da kuma halayen damuwa na yaro don a fitar da su, wanda zai iya ƙarfafa yaron da dangin su cimma sabon hangen nesa babu wanda yake jin an gurfanar da shi ko kuma an zarge shi.

Magungunan Tsarin da yawa:

Misali ya nuna nasara wajen ci gaba da ingantawa na dogon lokaci a cikin halayen yara da matasa. Iyalai a cikin MST sun nuna ingantaccen kwanciyar hankali na iyali da daidaitawa bayan magani da haɓaka tallafi, da rage rikici-ƙiyayya 

Babban manufofin hanyar sun haɗa da a) kawar da matsalolin halayyar, b) inganta aikin iyali, c) ƙarfafa ikon matasa don yin aiki mafi kyau a makaranta da sauran saitunan al'umma, da d) rage matsayi na waje 

 Rikici 
Disability rights organizations, such as the Bazelon Center for Mental Health Law, oppose placement in RTC programs, calling into question the appropriateness and efficacy of such placements, noting the failure of such programs to address problems in the child's home and community environment, and calling attention to the limited mental-health services offered and substandard educational programs.[<span title="This claim needs references to reliable sources. (May 2016)">citation needed</span>]  Concerns specifically related to a specific type of residential treatment center called therapeutic boarding schools include:

 Hanyoyin da ba su dace ba,
 Rashin kulawar likita,
 ƙuntataccen sadarwa kamar rashin samun damar samun kariya ga yara da wayar da kan jama'a, da
 rashin saka idanu da tsari.

Bazelon yana inganta ayyukan da ke tattare da al'umma bisa la'akari da cewa sun fi tasiri kuma ba su da tsada fiye da sanyawa a cikin gida.

Wani rahoto na 2007 ga Majalisa daga Ofishin Gudanar da Gwamnati (GAO) ya gano shari'o'in da suka shafi mummunar cin zarafi da sakaci a wasu daga cikin wadannan shirye-shiryen.

Daga ƙarshen 2007 zuwa 2008, babban hadin gwiwar masu zaman kansu, da kuma shahararrun kungiyoyin kiwon lafiya da na tunanin mutum kamar Alliance for the Safe, Therapeutic and Appropriate Use of Residential Treatment (ASTART) da Community Alliance for the Ethical Treatment of Youth (CAFETY), sun ba da shaida da tallafi wanda ya haifar da kirkirar Stop Child Abuse in Residential Programs for Matters Act of 2008 ta Kwamitin Majalisawa da Aiki.

Jon Martin-Crawford da Kathryn Whitehead na CAFETY sun ba da shaida a wani sauraron Kwamitin Majalisa na Amurka kan Ilimi da Aiki a ranar 24 ga Afrilu, 2008,  kuma sun bayyana ayyukan zamba da suka samu a Makarantar Gidauniyar Iyali da Makarantar Mountain, duka makarantun kwana na warkewa. 

Saboda rashin ka'idojin waɗannan shirye-shiryen da gwamnatin tarayya ta yi kuma saboda mutane da yawa ba sa ƙarƙashin lasisi ko saka idanu na jihar, Evaluating Private Residential Treatment Programs for Troubled Teens, FTC Urges Caution When Considering 'Boot Camps', FTC Federal Trade Commission, Retrieved May 1, 2009 Hukumar Ciniki ta Tarayya ta ba da jagora ga iyaye da ke la'akari da irin wannan sanyawa. Considering a Private Residential Treatment Program for a Troubled Teen? Questions for Parents and Guardians to Ask, FTC Federal Trade Commission, Retrieved May 1, 2009

Sau da yawa ana kama shirye-shiryen kula da gidaje a cikin wuta a lokacin gwagwarmayar kula da kulawa, yayin da iyaye da aka hana kula da su ke ƙoƙarin lalata matar da ke adawa da shirin magani.

 Bincike kan tasiri 
Nazarin hanyoyin magani daban-daban sun gano cewa maganin zama yana da tasiri ga mutanen da ke da dogon tarihin halayyar jaraba ko aikata laifuka.A National Evaluation of Treatment Outcomes for Cocaine Dependence; D. Dwayne Simpson, PhD; George W. Joe, EdD; Bennett W. Fletcher, PhD; Robert L. Hubbard, PhD; M. Douglas Anglin, PhD; Arch Gen Psychiatry. 1999;56:507-514. AbstractEffectiveness of coerced addiction treatment (alternative consequences) A review of the clinical research; Norman S. Miller M.D. and Joseph A. Flaherty M.D.b.; Journal of Substance Abuse Treatment, Volume 18, Issue 1, Pages 9-16 (January 2000) AbstractU.S. Department of Health and Human Services. NIDA InfoFacts: Treatment Approaches for Drug Addiction. Aug. 2007. 18 Oct. 2007.U.S. Department of Health and Human Services. Principles of Drug Addiction Treatment: A Research Based Guide. Feb. 2005. 18 Oct. 2007. RTCs suna ba da shirye-shiryen da aka tsara don magance takamaiman bukatun fursunoni. Duk da jayayya game da ingancin (RTCs), binciken da aka yi kwanan nan ya nuna cewa shirye-shiryen kula da gidaje na al'umma suna da sakamako mai kyau na dogon lokaci ga yara da matasa tare da matsalolin halayyar.

Wadanda suka halarci shirin matukin jirgi da ke amfani da kulawa ta iyali da kuma samfurin takwarorinsu mai kyau ba su nuna wani abin da ya faru na tserewa ba, halayyar cutar kai, ko tashin hankali na jiki, kuma kawai lamari ɗaya na lalacewar dukiya idan aka kwatanta da ƙungiyar sarrafawa (Holstead, 2010).   Nasarar magani ga yara a cikin RTCs ya dogara sosai da asalin su watau, yanayin su, halin da ake ciki, yanayi da halin da ake yi kafin fara magani. Yaran da suka nuna ƙananan matsalolin halayyar ciki da waje a lokacin cin abinci kuma suna da ƙananan matakin fallasawa ga abubuwan muhalli marasa kyau (misali, tashin hankali na gida, amfani da kayan iyaye, yawan aikata laifuka), sun nuna sakamako mafi kyau fiye da yara waɗanda alamun su sun fi tsanani (den Dunnen, 2012). 

Ƙarin bincike ya nuna cewa maganin da aka tsara, ko sanin lokacin da ake tsammani na magani, yana da alaƙa sosai da sakamako mai kyau na magani. Sakamakon dogon lokaci ga yara ta amfani da maganin da aka tsara ya nuna cewa suna da kashi 21% da ba za su iya shiga cikin halayyar aikata laifuka ba kuma kashi 40% da ba za a iya buƙatar asibiti don matsalolin lafiyar kwakwalwa (Lindqvist, 2010).  Akwai ƙarin shaidu da ke tallafawa tasirin RTCs na dogon lokaci ga yara da ke nuna matsalolin lafiyar kwakwalwa. Preyde (2011)  ya gano cewa abokan ciniki sun nuna raguwar ƙididdiga a cikin tsananin bayyanar cututtuka watanni 12-18 bayan barin RTC, sakamakon da aka kiyaye watanni 36-40 bayan an sallame su daga wurin.

Koyaya, kodayake akwai bincike mai yawa da ke tallafawa ingancin RTCs a matsayin hanyar kula da yara da matasa tare da rikice-rikicen halayyar, ba a san komai game da ayyukan sa ido na irin waɗannan wuraren ba. Wadanda ke bin diddigin abokan ciniki bayan sun bar RTC suna yin hakan ne kawai na matsakaicin watanni shida. Don ci gaba da samar da ingantaccen magani na dogon lokaci ga mutanen da ke cikin haɗari, ana buƙatar ƙarin ƙoƙari don ƙarfafa saka idanu kan sakamakon bayan an sallame su daga maganin zama (JD Brown, 2011). 

Ɗaya daga cikin matsalolin da ke hana tasirin RTCs shine tserewa ko "tsere". Binciken da Kashubeck ya yi ya gano cewa masu tserewa daga RTCs "mafi yiwuwa su sami tarihin tserewa, tarihin da ake zargi da cin zarafin jima'i, bincike na rikice-rikice, da iyaye waɗanda aka dakatar da hakkinsu. "  Ta hanyar amfani da waɗannan halaye na marasa lafiya a cikin ƙirar magani, RTCs na iya samun nasara wajen rage tserewa kuma in ba haka ba inganta yiwuwar nasarar abokan ciniki.

 Dubi kuma 


 manazarta 

 Ƙarin karantawa 



 Haɗin waje 

Rukuni:Shafuka masu fassarorin da ba'a duba ba