Assessing the Effectiveness of Care for Youth with Severe Emotional Disturbances

Abstract

Limited information exists regarding how some popular measures for assessing the effectiveness of services to children with severe emotional disturbance interrelate when used as part of ongoing outcome accountability systems. This article examines the interrelationships--at intake and over time-between the Child Behavior Checklist ( CBCL), the Youth Self Report (YSR), the Child and Adolescent Functional Assessment Scale (CAFAS), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) clinical diagnoses across six California care systems. At intake, there were mild to moderate relationships between the clinical diagnosis, the CAFAS, the CBCL, and the YSR. These relationships were not as strong as those found in other studies conducted in more controlled research environments. There was limited agreement among the CAFAS, the CBCL, and the YSR regarding the outcomes of the youths served. These findings raise questions regarding translating measures from research settings to clinical environments and reconciling differences between outcome measures.

Children’s Mental Health

“…At the same time, divergent respondent perspectives should provide greater insight for more comprehensive treatment planning (Rosenblatt & Rosenblatt, 2002). The significant predictive value of caregiver strain validates the importance of family support within the treatment planning process (Heflinger, Northrup, Sonnichsen, & Brannan, 1998).…”

“…parent versus child) can be useful for individual treatment planning (Rosenblatt & Rosenblatt, 2002), more sophisticated research methodologies are needed to better understand how differing perspectives and interactions thereof should be considered when evaluating service outcomes. As such, analyses of differential patterns of change by subgroups (e.g., level of severity, by diagnoses, by gender) may provide more specific information for interpreting outcome data.…”

“…A growing number of studies have been conducted to examine the impact of service on outcomes, such as adaptive functioning or symptom severity (Epstein, Kutash, & Duchnowski, 1998). Despite an increased focus on outcome, studies of the relationship among outcomes for children with serious emotional and behavioral disabilities are scant (Rosenblatt & Rosenblatt, 2002). The current study examined changes in functioning and hopefulness across time from both the child and parent perspective, and the predictive properties of selected outcome measures on improved functioning after six months in service.…”