Long-term Outcomes of Children and Youth accessing Residential or Intensive Home-based Treatment: Three year follow up

Abstract

In this study the long-terms outcomes of children and youth with severe mental health problems receiving residential treatment (RT) or an intensive homebased treatment (IHT) were reported. RT is 24-hour mental health intervention in a highly supervised and structured group living setting where individualized and related therapies are provided. Youths attend a day school within the residential environment. IHT developed as an alternative to residential treatment for youth and comprises the same therapeutic interventions provided in the home as opposed to the residential setting. Youths attend their regular school which could be within a specialized setting, such as a day school. At discharge, there were statistically and clinically significant improvements in psychosocial functioning for children and youth in RT and IHT. There were also statistically significant improvements in scores on symptom severity from admission to 12 to 18 months post-discharge, and these improvements were maintained at 36 to 40 months post-discharge. Differences in demographic data between the two groups suggest that the programs may serve two different populations, and that both programs are important components of a comprehensive mental health plan for children and youth.

Promoting Stability for Youth Returning from Residential Care: Attorney Perspectives

“…Youth in residential care receive services for a variety of mental and behavioral health concerns, which can include internalizing and externalizing disorders, drug or alcohol dependency, trauma and abuse, delinquency (Briggs et al., ; Connor, Miller, Cunningham, & Melloni, ; Farmer, Dorsey, & Mustillo, ; Larzelere, Daly, Davis, Chmelka, & Handwerk, ; Lyons & Schaefer, ), academic problems (Trout et al., ), and physical health needs (Nelson et al., ). Recognizable gains can be made in care (Larzelere et al., ; Preyde, Frensch et al., ; Scott & Lorenc, ), but these gains may not be sustained once a youth returns to his or her home environment. The result may be return to care following discharge (McMillen, Lee, Johnson‐Reid, ; Narendorf & McMillen, ).…”

Clinical Gains for Youth in Psychiatric Residential Treatment Facilities: Results from a State-Wide Performance Information System

“…A study by Preyde et al (2011) measuring psychosocial functioning and symptom severity at 18-24 months and 36-40 months post-discharge identified both progress during treatment and a continuation of these gains at 3 years post-discharge for many children and youth who received residential treatment services.…”

“…In an effort to establish a greater fit between needs and services, research is increasingly focusing on the characteristics of children and youth who achieve the greatest benefits from residential treatment services (Knorth, Harder, Zandberg, & Kendrick, 2008;Preyde et al, 2011). There is some indication that residential treatment provides a viable alternative for youth with more severe behavioral difficulties who are unable or unwilling to access community-based provision (Preyde et al).…”

Therapeutic Engagement of Adolescents with Emotional and Behavioral Disorders

“…In one Canadian study, only clinical outcomes of youth accessing residential treatment centers were reported using standardized measures of symptom severity and functioning (Preyde, Cameron, Frensch, & Adams, 2011a;Preyde et al, 2011b). Significant improvements (in mood severity, self-harm behavior, behavior towards others, antisocial behavior) were demonstrated from admission to discharge and a 3 year follow-up.…”

“…The goal of service providers at residential treatment programs is not necessarily to eliminate chronic symptoms, but to stabilize the child's level of functioning and allow for a continuum of services that aid youth in managing their symptoms and improve their quality of life once residential treatment youth are discharged into the care of community mental healthcare. The average length of stay can be 6-9 months (Preyde et al, 2011b) which provides time for engagement, and the therapeutic relationship has been shown to positively associate with client outcomes in other populations (Karver et al, 2006;Lambert & Barley, 2001). Therefore, examining youth engagement with these at-risk youth may foster understanding of clinical outcomes.…”