Longitudinal evaluation of outcomes for youth with serious emotional disturbance during two years of Children’s Psychosocial Rehabilitation

Abstract

This study assessed the course, rate, and significance of change in participants’ day-to-day functioning during two years of Children’s Psychosocial Rehabilitation (CPSR). Hierarchical linear mixed models were used to analyze Child and Adolescent Functional Assessment Scale (CAFAS) outcome data for 49 youth with serious emotional disturbance, aged 7 to 17 years. The authors estimated participants’ change trajectory, difference in initial versus 16-month status, and difference in rate of change between the first 12 and last 8 months of the study. Controlling for age, participants improved by 13.73 points on the CAFAS every four months, generating a statistically and clinically significant improvement from intake to 16 months. The rate of change decreased significantly to 1.37 points per wave during the last 8 months of the study. CPSR participants improve significantly during treatment, with the majority of changes occurring in the first year.

Dose-Effect of Children’s Psychosocial Rehabilitation on the Daily Functioning of Youth with Serious Emotional Disturbance

“…More hours of CPSR predicted greater gains in following rules at home, passing classes at school, feeling less depressed and anxious, having fewer suicidal thoughts and self-harm behaviors, and maintaining better relationships with peers and adults. In this study, as in previous studies (Williams 2009;Williams and Sherr 2008), children who received CPSR as part of their treatment plan had better odds of achieving positive change in their daily lives. Children's psychosocial rehabilitation's unique characteristics and its association with positive outcomes in this and other studies may make it a valuable addition to the SED treatment armamentarium (e.g., Burns and Hoagwood 2002).…”

“…CPSR is deployed in at least 6 States (Kansas, Texas, Nevada, Arizona, Missouri, and (Williams 2009;Williams and Sherr 2008) and no national agenda exists for program development or evaluation.…”

“…The findings were biased, however, given the high percentage of children who received concurrent psychotherapy and medication during the trial ([70%). The second study followed 49 children during 2 years of participation in CPSR and found that children's functioning improved steadily during the first 16 months of treatment and remained stable for the next 8 months; again, the positive findings were confounded by children's receipt of concurrent therapies (Williams and Sherr 2008). These naturalistic studies provided preliminary information on children's pattern of change while participating in CPSR; they failed, however, to account for children's receipt of concurrent medication and psychotherapy or to address the dose-effect relationship in CPSR.…”

“…The children were consecutive new enrollees who entered the program from November 2006 through January 2008. The inclusion dates were purposively selected to avoid overlap with earlier uncontrolled evaluations of the program (Williams 2009;Williams and Sherr 2008). Data collection proceeded following approval from Boise State University's Internal Review Board.…”

Oh How I Try to Use Evidence in my Social Work Practice: Efforts, Successes, Frustrations, and Questions

“…I successfully implemented the dose-effect study (Williams, 2009b), and in collaboration with fellow clinicians wrote a treatment manual (Williams, Richards, Priest, Stockett, & Thompson, 2009), and developed and preliminarily validated a treatment fidelity measure for our program (Williams, Oberst, Campbell, & Lancaster, 2011). We examined whether certain populations benefited as much from the intervention as others (Williams & Sherr, 2009) and whether the program exhibited long-term effects on children's daily functioning (Williams & Downloaded by [York University Libraries] at 21:03 16 November 2014 Sherr, 2008). All of these were planned efforts to gradually evaluate and empirically inform our child PSR program model.…”