A summary measure of client level of functioning: Progress and challenges for use within mental health agencies

Pokorny, Lois J.

doi:10.1007/bf02518602

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…The CAFAS can be useful for a variety of administrative purposes, including linking level of care to level of need (Newman, Griffin, Black, & Page, 1989;Newman & Hodges, 1995), program evaluation and planning (Herman & Mowbray, 1991;Pokorny, 1991), conducting client oriented cost outcome studies (Newman, Burwell, & Underhill, 1978), and providing information to consumers, consistent with the notion of developing provider "report cards" (Freeman & Trabin, 1994). The CAFAS is also useful for clinical decision-making about individual consumers.…”

Section: Discussionmentioning

confidence: 99%

Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale

1996

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The Child and Adolescent Functional Assessment Scale (CAFAS) is a multidimensional measure of degree of impairment in functioning. Interrater reliability data are presented for lay raters, graduate students, and frontline staff. Reliability was high for the total score and behaviorally-oriented scales. Construct, concurrent, and discriminant validity were assessed with the sample of children and adolescents evaluated at the Fort Bragg Demonstration Evaluation Project. Youth and their caregivers were evaluated via interview and selfcompleted instruments at four time points. Significant correlations were found between the CAFAS and other related constructs. Concurrent validity was demonstrated by logistic regression analyses examining the relationship between CAFAS ratings and problematic behaviors endorsed on measures completed by parents, teachers, or the youth. Youth with higher CAFAS total scores were much more likely to have poor social relationships, difficulties in schoo~ and problems with the law. Discriminant validity was assessed with a repeated measures analysis of variance with intensity of care at intake and time as factors. Youth who were inpatients or in residential treatment centers at intake had higher CAFAS scores than those who were outpatients. These findings provide strong evidence for the reliability and validity of the CAFAS.

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Section: Discussionmentioning

confidence: 99%

Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale

1996

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“…The PECFAS's focus on behavioral descriptions of impairment and its depiction of the young child's functioning across domains make it a useful organizing tool for treatment planning among staff and with parents as well as providing a way to prioritize which preschool-aged children and their families would most benefit from expanded services. This in turn would provide a way to link level of care to level of need (Newman & Hodges, 1995), conduct program evaluation and planning (Pokorny, 1991), and analyze costs vs. benefits.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS)

Murphy

Pagano

Ramirez³

et al. 1999

Journal of Child and Family Studies

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Efforts to determine the prevalence of serious emotional disturbance in preschool-aged children have been hampered by the lack of a validated measure. The Preschool and Early Childhood Functional Assessment Scale (PECFAS) is a multi-dimensional measure that assesses the psychosocial functioning of children aged 3-7 years. The concurrent validity and reliability of the PECFAS were assessed in a sample of 30 preschool-aged children in a large Head Start program in Ventura, California. PECFAS ratings based on in-depth interviews were significantly related to parental ratings that the children had mental health problems, psychiatric diagnoses, teacher ratings of the child's need for mental health evaluations, teacher ratings of behavior problems on a standardized screening inventory (DIAL-R), and actual referrals for mental health evaluations. Interrater reliability for the total PECFAS score was high (r = .90) as was internal consistency of the five subscales (alpha = .86). Using the PECFAS scores as a standard, the weighted prevalence of serious emotional disturbance in this West Coast Head Start program was 17%, at the lower end of the current estimated rate of SED for older children in low income samples (18-26%).

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“…It helps linking the level of care and the level of need (Detroit Wayne Mental Health Authority, 2015; Newman et al, 1989;Newman and Hodges, 1995), program evaluation and planning (CAFAS In Ontario, 2017;Detroit Wayne Mental Health Authority, 2015;Herman and Mowbray, 1991;Pokorny, 1991), and predicting subsequent service utilization and associated costs (Detroit Wayne Mental Health Authority, 2015;Hodges and Wong, 1996). Previous studies on the scale also indicated its usefulness in clinical settings, such as case formulation, tracking changes in functioning over time (Boydell et al, 2005;Detroit Wayne Mental Health Authority, 2015), and clinical decision-making about individual consumers (Hodges and Wong, 1996).…”

Section: Introductionmentioning

confidence: 99%

Predictors of functional improvement in children and adolescents at a publicly funded specialist outpatient treatment clinic in a Canadian Prairie City

D’Arcy

Meng

2019

Psychiatry Research

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Children's mental health problems substantially impact their functioning. For clinically treated children and adolescents, we explored the impact of mental health treatment on functioning and identified predictors of functional improvement. Outpatient clinical data from a regional publicly funded specialist outpatient treatment clinic were analyzed. The Child and Adolescent Functional Assessment Scale (CAFAS) was used to assess outcomes. Non-parametric tests were used to compare baseline and exit scores. Logistic regression analysis was used separately for children and adolescents to examine predictors of improvement. Total CAFAS scores at exit showed a significant decrease from initial scores for both age groups, indicating improvements in clients' functioning. Children and adolescents had shared predictors for initial level of dysfunction, length of treatment and the presence of pervasive behavioural impairment (PBI). Primary presenting problem, caregiver support and area of residence were only associated with outcome among children. Clients with higher initial levels of dysfunction and PBI require longer treatment cycles to reach an acceptable outcome. Shortening the length of treatment cycles may improve the efficiency of resource use but can be detrimental to some clients. Personalized treatment should be tailored to the clients with specific characteristics and needs.

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A summary measure of client level of functioning: Progress and challenges for use within mental health agencies

Cited by 11 publications

References 13 publications

Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale

Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale

Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS)

Predictors of functional improvement in children and adolescents at a publicly funded specialist outpatient treatment clinic in a Canadian Prairie City

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