What are “good outcomes” for adolescents in public mental health settings?

Abstract

BackgroundIn line with the evidence-based paradigm, routine outcome monitoring and clinical feedback systems are now being recommended and implemented in youth mental health services. However, what constitutes a good outcome for young service users is not fully understood. In order to successfully monitor outcomes that are clinically and personally relevant for the service user that are to benefit from these systems, we need to gain more knowledge of what young service users value as meaningful outcomes of youth mental health services.AimTo contribute knowledge into what constitutes “good outcomes” from the experiences of adolescent service users in public mental health systems.MethodsA qualitative in-depth study of the experiences and reflections from 22 adolescents aged 14–19 years, currently or recently being in public mental health services. The data material was analyzed using a systematic step-wise consensual qualitative research framework for team-based analysis.ResultsAn overarching theme of outcome as having developed a stronger autonomy and safer identity emerged from the analysis, with the subsequent five constituent themes, named from the words of the adolescent clients: (1) I’ve discovered and given names to my emotions, (2) I’ve started to become the person that I truly am, (3) I’ve dared to open up and feel connected to others, (4) I’ve started saying yes where I used to say no, and, (5) I’ve learned how to cope with challenges in life.Conclusion“Good outcomes” in youth mental health services should be understood as recovery oriented, sensitive to developmental phases, and based on the personal goals and values of each adolescent client.

Review: What Outcomes Count? Outcomes Measured for Adolescent Depression Between 2007 and 2017

“…26,[48][49][50] Two recent taxonomies emphasized the importance of measuring domains beyond symptoms, 17,20 as did a small number of qualitative studies. 51,52 However, with the exception of 1 study, 53 none of the reviewed studies referred to this emerging literature or discussed their measurement approach from a multidimensional perspective.…”

‘Nobody else can lead your life’: What adolescents need from psychotherapists in change processes

“…Eclectic approaches and conceptual models (such as CBT) were utilised, based on the clinician's background and each patient's needs and preferences. We studied three research questions and one article reporting on a different set of analyses to a separate research question has been published elsewhere (Lavik, Veseth, Frøysa, Binder & Moltu, 2018).…”

A comprehensive mapping of outcomes following psychotherapy for adolescent depression: The perspectives of young people, their parents and therapists

“…Existing studies exploring their notions of 'good outcome' have drawn attention to a broader range of themes, as well as divergent priorities between groups. Adolescents have tended to emphasize changes in their ability to understand and cope with feelings and thoughts; greater connectedness with others; a stronger sense of self; and increased hope [17][18][19][20][21]. Parents have been found to value outcomes related to managing youth behavior; and therapists have been seen to focus on intermediate outcomes linked to their training and approach [22,23].…”