Reliable Change and Outcome Trajectories Across Levels of Care in a Mental Health System for Youth

Jackson, David S.; Keir, Scott S.; Sender, Max; Mueller, Charles W.

doi:10.1007/s10488-015-0690-5

Cited by 14 publications

(5 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study tested variables relationships with speed of improvement. For some factors, findings were broadly consistency with the literature e.g., higher baseline scores predict faster improvement [12,38,15], however, for others findings were more discrepant. Firstly, we found that older adolescents had higher baseline scores, but also improved more rapidly than younger ones.…”

Section: Discussionsupporting

confidence: 80%

Trajectories of change of youth depressive symptoms in routine care: shape, predictors, and service-use implications

Napoleone

Evans

Patalay

et al. 2019

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

Objective: Depression is one of the main reasons for youth accessing mental health services, yet we know little about how symptoms change once youth are in routine care. This study used multilevel modelling to examine the average trajectory of change and the factors associated with change in depressive symptoms in a large sample of youth seen in routine mental health care services in England.Method: Participants were 2,336 youth aged 8 to 18 (mean age = 14.52; 77% females; 88% white ethnic background) who tracked depressive symptoms over a period of up to 32 weeks while in contact with mental health services. Explanatory variables were age, gender, whether the case was closed, total length of contact with services, and baseline severity in depression scores.Results: Faster rates of improvement were found in older adolescents, males, those with shorter time in contact with services, closed cases, and those with more severe symptoms at baseline. Conclusions:This study demonstrates that, when youth self-report their depressive symptoms during psychotherapy, symptoms decrease in a linear trajectory. Attention should be paid to younger people, females, and those with lower than average baseline scores, as their symptoms decrease at a slower pace compared to others.

show abstract

Section: Discussionsupporting

confidence: 80%

Trajectories of change of youth depressive symptoms in routine care: shape, predictors, and service-use implications

Napoleone

Evans

Patalay

et al. 2019

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

show abstract

“…This is in line with earlier studies that demonstrate a curvilinear outcome response, with initial rapid improvement rates followed by a decelerating curve over the course of treatment. 30,[94][95][96] The moderator analysis suggested that, in line with previous research, informant perspective moderates outcomes, with clinician reports generally documenting greater improvements than self-or parent-reports. 97 This highlights the need to ensure the views of patients themselves are considered wherever possible if patient shared decisions and empowerment are to be made a reality.…”

Section: Discussionsupporting

confidence: 66%

“…27 There may be several person-and treatmentrelated variables that act as moderators, including but not limited to problem type, comorbidity, treatment length, and outcome informant. [28][29][30][31][32][33] Outcome moderation within this context warrants further investigation and is crucial for delineating the factors that may enhance or reduce clinical effectiveness in routine practice. This information may prove to be decisive in enabling clinicians to be prescriptive in their choice of treatment based on the likely outcome on an individual basis.…”

mentioning

confidence: 99%

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

Bear

Edbrooke‐Childs

Norton

et al. 2020

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

Objective: Depression and anxiety are the most prevalent mental health problems in youth, yet almost nothing is known about what outcomes are to be expected at the individual level following routine treatment. This paper sets out to address this gap by undertaking a systematic review of outcomes following treatment as usual (TAU) with a particular focus on individual-level outcomes. Method: MEDLINE, Embase and PsycInfo were searched for articles published between 1980 and January 2019 that assessed TAU outcomes for youth depression and anxiety accessing specialist mental health care. Meta-analysis considered change at both group-level preÀpost effect size (ES) and individual-level recovery, reliable change, and reliable recovery. Temporal analysis considered stability of primary and secondary outcomes over time. Subgroup analysis considered the moderating effect of informant; presenting problem; study design; study year; mean age of youth; use of medication; intervention dosage and type of treatment offered on outcomes. A protocol was preregistered on PROSPERO (CRD42017063914). Results: Initial screening of 6,350 publications resulted in 38 that met the inclusion criteria, and that were subsequently included in meta-analyses. This resulted in a final full pooled sample of 11,739 young people (61% of whom were female, mean age 13.8 years). The preÀpost ES (Hedges' g) at first/final outcome (13/26 weeks) was À0.74/À0.87. The individual-level change on measures of self-report was 38% reliable improvement, 44% no reliable change, and 6% reliable deterioration. Outcomes varied according to moderators, informant, problem type and dosage. Conclusion: Poor data quantity and quality are limitations, but this is the first study that indicates likely rates of reliable improvement for those accessing TAU. We propose the need for improved reporting of both individual-level metrics and details of TAU to enable greater understanding of likely current outcomes from routine care for youths with depression and anxiety in order to allow the potential for further improvement of impact.

show abstract

“…MTPS treatment targets are moderately stable across treatment months (Nakamura et al, 2007), are predictably associated with Diagnostic and Statistical Manual diagnoses and factor in an expected way (Daleiden et al, 2004; Love et al, 2018; Nakamura et al, 2007). Significant associations have been found between MTPS progress ratings and other measures of treatment outcome, including discharge status and change in functioning (Jackson et al, 2017). Substance use is the critical target for this study serving both as an inclusion criteria and as the basis for the associated progress ratings used as the measure of substance use treatment gains.…”

Section: Methodsmentioning

confidence: 99%

Predicting substance use treatment progress for geographically isolated adolescents in community care.

Hee¹,

Mueller²

2022

Journal of Rural Mental Health

Self Cite

View full text Add to dashboard Cite

i at Ma ¯noa Geographically isolated adolescents and families face barriers that might interfere with substance use treatment progress. Empirical literature for rural isolated youth is limited and it is unclear what therapeutic practices and approaches are associated with their substance use treatment progress. In a study of youth in Hawai'i receiving in-home treatment (N = 634), geographically isolated adolescents made comparable treatment progress relative to their nonisolated peers and had families that were somewhat more likely to be involved in treatment. Multilevel modeling indicated more practice techniques focused on the youth and/or the family predicted better progress. When entered simultaneously, youth-focused practices were the only significant predictor. Consistent monthly youth involvement in treatment predicted better progress, but this was not true for family involvement in sessions. Hawai'i's geographically isolated youth, their ecologies, and system of care policies might contribute to protective factors that support treatment progress, distinguishing them from youth in rural-based treatment studies elsewhere. Public Health Significance StatementGeographically isolated adolescents and their families face several barriers that might interfere with substance use treatment progress. This study found that geographically isolated adolescents in Hawai'i receiving in-home treatment made similar progress in comparison to their nonisolated peers, and had families who were more often involved in services. Further, youth involvement in treatment, and treatment practices focused on both the youth and/or the family predicted better progress.

show abstract

Reliable Change and Outcome Trajectories Across Levels of Care in a Mental Health System for Youth

Cited by 14 publications

References 55 publications

Trajectories of change of youth depressive symptoms in routine care: shape, predictors, and service-use implications

Trajectories of change of youth depressive symptoms in routine care: shape, predictors, and service-use implications

Systematic Review and Meta-analysis: Outcomes of Routine Specialist Mental Health Care for Young People With Depression and/or Anxiety

Predicting substance use treatment progress for geographically isolated adolescents in community care.

Contact Info

Product

Resources

About