Home-Based Multisystemic Therapy as an Alternative to the Hospitalization of Youths in Psychiatric Crisis: Clinical Outcomes

Henggeler, Scott W.; Rowland, Melisa D.; Randall, Jeff; Ward, David M.; Pickrel, Susan G.; Cunningham, Phillippe B.; Miller, Stacey L.; Edwards, James E.; Zealberg, Joseph J.; Hand, Lisa D.; Santos, Alberto B.

doi:10.1097/00004583-199911000-00006

Cited by 290 publications

(267 citation statements)

References 26 publications

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“…In addition, common caregiver obstacles to such intensive participation in treatment include lack of transportation, child care, and relief from other demands. In this context, home-based aftercare services (e.g., Henggeler et al, 1999) may fill a critical need for this patient group; however, their availability is uneven and the effectiveness of the various formats in use requires further examination. Children at the highest risk for rehospitalization had caregivers who reported low parenting stress in tandem with other risk factors.…”

Section: Discussionmentioning

confidence: 99%

Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization Within One Year of Discharge

Blader

2004

Journal of the American Academy of Child & Adolescent Psych

123

135

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Objective-To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization.Method-One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via the Cox proportional hazards model, were symptom and family factors assessed at admission, aspects of psychiatric treatment, and demographic variables.Results-The Kaplan-Meier rehospitalization risk within 1 year of discharge, taking into account known readmissions and censored observations, was 0.37. Most readmissions (81%) occurred within 90 days of discharge. Four variables contributed simultaneously to predicting readmission risk. More severe conduct problems, harsh parental discipline, and disengaged parent-child relations conferred a higher risk for rehospitalization; these risks were attenuated when parents disclosed higher stress in their parenting roles. Conclusions-Findingsshowed that psychiatric rehospitalization of children is common, most likely in the trimester after discharge, and highly related to both child symptoms and family factors measurable at admission. Results suggest that efforts to improve postdischarge outcomes of children should target the initial period following inpatient care, address vigorously the complex treatment needs of those with severe conduct problems, and aim to improve parent-child relations.

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Section: Discussionmentioning

confidence: 99%

Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization Within One Year of Discharge

Blader

2004

Journal of the American Academy of Child & Adolescent Psych

123

135

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“…In one report, home-based multisystemic family therapy was suggested as a safe alternative to hospitalization (21), but the study was limited by an overrepresentation of patients of lower socioeconomic status, hospitalization of a large number of patients in the experimental group (44 percent), failure to note suicidality levels, and the use of an intervention that had limited generalizability because it was highly specialized.…”

mentioning

confidence: 99%

A Rapid-Response Outpatient Model for Reducing Hospitalization Rates Among Suicidal Adolescents

Greenfield¹,

Larson²,

Hechtman³

et al. 2002

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“…The research support for MST suggests that youth who receive this multi-level, multi-system support have reduced rates of suicidality, improved family functioning, improved school attendance, and reduced rates of externalizing behavior (Henggeler, et al, 1999;Huey et al, 2004;Rowland, et al, 2005;Schoenwald, Ward, Henggeler, & Rowland, 2000). MST offers a model that we believed generalized to the new level of care we sought to add to the private mental healthcare system.…”

Section: Natural Mentorsmentioning

confidence: 99%

Inventing a Wheel: Mission Driven Innovations to Boost Post Residential Treatment Outcomes

Thayne¹

2017

JTSP

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The Merriam-Webster dictionary defines innovation as "the act or process of introducing new ideas, devices, or methods," to which I would only add the critical phrase where a need exists. With respect to therapeutic schools and programs, the most glaring need has been to identify/devise a more effective means of transitioning a client from treatment back to his or her home or other real-world setting. In this article, I share a journey of innovation that led to increased success after treatment. At the heart of each innovation was the drive to create real change that lasts. Factors that influenced the success of each collection of innovations are outlined for each respectively. This article shares a clinical journey of innovation that began during graduate school and has continued in different yet related fields for over 20 years. It presents factors that enabled innovation to occur, as well as some of the particular clinical advances made over the course of this journey. The autobiographical "voice" of the paper was chosen to present innovation from the perspective of an innovator, with a focus on the unfolding process of innovation: this is a case study. My goal is to provide practical ideas that can be adopted and adapted to fit different programs' needs while also shedding light on some of the conditions that empower innovators, facilitate innovation, and drive progress. BackstoryMy first attempt to apply creativity and innovation to a significant problem occurred while I was a Ph.D. candidate at Virginia Tech. Though I had a Masters degree in Marriage and Family Therapy and a part time private practice, I also had a keen interest in leadership and organizational development and wondered how these fields could be synthesized. So, I endeavored to explore my interests in applying marriage and family therapy to business organizations. My dissertation committee consisted of professors with backgrounds in Organizational Development, Business Management, Statistics, Management Systems Engineering and, of course, Marriage and Family Therapy.Ultimately, I found myself working as a contract trainer and consultant to a large health care provider consisting of several hospitals, dozens of specialty care centers, and many advanced primary care practices. The job I was hired to do was to help heal a culture of distrust, resistance, and interdepartmental conflict that had grown during the acquisition and restructuring of regional hospitals and clinics that had been purchased and then placed under a large corporate umbrella. As it turned out, the ideas I had been developing for my dissertation research proved to be perfectly suited to this need. With the help of three corporate employees in the HR department, I delivered an intensive leadership program for all executive and management levels in the organization. Due to the health care provider's readiness for change and a commitment to the process, the program was considered a success and was given credit for healing a conflict-ridden culture and for bringing about...

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Home-Based Multisystemic Therapy as an Alternative to the Hospitalization of Youths in Psychiatric Crisis: Clinical Outcomes

Cited by 290 publications

References 26 publications

Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization Within One Year of Discharge

Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization Within One Year of Discharge

A Rapid-Response Outpatient Model for Reducing Hospitalization Rates Among Suicidal Adolescents

Inventing a Wheel: Mission Driven Innovations to Boost Post Residential Treatment Outcomes

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