C. Wayne Jones, Steve Simms, Jesse Troy, Scott Suhring, Dan Warner, Tara Byers
{"title":"对全州范围内的强化居家家庭治疗项目中严重情感障碍青少年的治疗时间、功能和家庭外安置之间关系的档案研究","authors":"C. Wayne Jones, Steve Simms, Jesse Troy, Scott Suhring, Dan Warner, Tara Byers","doi":"10.1007/s10826-024-02906-y","DOIUrl":null,"url":null,"abstract":"<p>The main aim of this study was to evaluate the effectiveness of Pennsylvania’s state-wide intensive in-home treatment for youth with serious emotional disturbance (SED), EcoSystemic Structural Family Therapy-Family Based Mental Health Services (ESFT-FBMHS). Despite its long history of implementation, the program remains empirically under-evaluated. In this archival study, out-of-home placement and youth functioning outcomes were compared across four tiers of length of stay. Given the high-risk population treated in ESFT-FBMHS, it was hypothesized that the families and youth who completed the full duration of treatment (169–224 days) would have better outcomes than those who stopped treatment after 168 days or less. We utilized an ex post facto quantitative research design analyzing archived medical claims data of 2251 youth treated between 2018 and 2022 to assess out-of-home placement rates and analyzed archived data from six domains of the Child and Adolescent Needs and Strengths (CANS; Problem Presentation, Risk Behaviors, Functioning, Child Safety, Caregiver Needs, and Child Strengths) to assess changes in youth functioning post-discharge (90 and 180 days). An analysis using generalized estimating equations (GEE), controlling for potential confounding variables such as demographics and clinical features, suggest that length of stay in ESFT-FBMHS was significantly associated with out-of-home placement and youth improvement on the CANS at both 90- and 180-days post-discharge. As a group, youth with SED who did not complete the full duration of the program had 2–3 times the odds of out-of-home placement at 90 days post-discharge and 1–3 times the odds at 180 days post-discharge as compared to program completers. CANS scores showed improvement in 40.1% of youth who completed the program as compared to only 11.7%–18.2% for those who did not. The results of this study suggest that ESFT-FBMHS is effective for youth with SED as a group and can improve youth functioning and reduce out-of-home placement.</p>","PeriodicalId":48362,"journal":{"name":"Journal of Child and Family Studies","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An Archival Study of the Relationship Between Treatment Duration, Functioning, and Out-of-Home Placement for Youth with Serious Emotional Disturbance in a State-Wide Intensive In-Home Family Treatment Program\",\"authors\":\"C. Wayne Jones, Steve Simms, Jesse Troy, Scott Suhring, Dan Warner, Tara Byers\",\"doi\":\"10.1007/s10826-024-02906-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The main aim of this study was to evaluate the effectiveness of Pennsylvania’s state-wide intensive in-home treatment for youth with serious emotional disturbance (SED), EcoSystemic Structural Family Therapy-Family Based Mental Health Services (ESFT-FBMHS). Despite its long history of implementation, the program remains empirically under-evaluated. In this archival study, out-of-home placement and youth functioning outcomes were compared across four tiers of length of stay. Given the high-risk population treated in ESFT-FBMHS, it was hypothesized that the families and youth who completed the full duration of treatment (169–224 days) would have better outcomes than those who stopped treatment after 168 days or less. We utilized an ex post facto quantitative research design analyzing archived medical claims data of 2251 youth treated between 2018 and 2022 to assess out-of-home placement rates and analyzed archived data from six domains of the Child and Adolescent Needs and Strengths (CANS; Problem Presentation, Risk Behaviors, Functioning, Child Safety, Caregiver Needs, and Child Strengths) to assess changes in youth functioning post-discharge (90 and 180 days). An analysis using generalized estimating equations (GEE), controlling for potential confounding variables such as demographics and clinical features, suggest that length of stay in ESFT-FBMHS was significantly associated with out-of-home placement and youth improvement on the CANS at both 90- and 180-days post-discharge. As a group, youth with SED who did not complete the full duration of the program had 2–3 times the odds of out-of-home placement at 90 days post-discharge and 1–3 times the odds at 180 days post-discharge as compared to program completers. CANS scores showed improvement in 40.1% of youth who completed the program as compared to only 11.7%–18.2% for those who did not. The results of this study suggest that ESFT-FBMHS is effective for youth with SED as a group and can improve youth functioning and reduce out-of-home placement.</p>\",\"PeriodicalId\":48362,\"journal\":{\"name\":\"Journal of Child and Family Studies\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Child and Family Studies\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1007/s10826-024-02906-y\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"FAMILY STUDIES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Child and Family Studies","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1007/s10826-024-02906-y","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"FAMILY STUDIES","Score":null,"Total":0}
An Archival Study of the Relationship Between Treatment Duration, Functioning, and Out-of-Home Placement for Youth with Serious Emotional Disturbance in a State-Wide Intensive In-Home Family Treatment Program
The main aim of this study was to evaluate the effectiveness of Pennsylvania’s state-wide intensive in-home treatment for youth with serious emotional disturbance (SED), EcoSystemic Structural Family Therapy-Family Based Mental Health Services (ESFT-FBMHS). Despite its long history of implementation, the program remains empirically under-evaluated. In this archival study, out-of-home placement and youth functioning outcomes were compared across four tiers of length of stay. Given the high-risk population treated in ESFT-FBMHS, it was hypothesized that the families and youth who completed the full duration of treatment (169–224 days) would have better outcomes than those who stopped treatment after 168 days or less. We utilized an ex post facto quantitative research design analyzing archived medical claims data of 2251 youth treated between 2018 and 2022 to assess out-of-home placement rates and analyzed archived data from six domains of the Child and Adolescent Needs and Strengths (CANS; Problem Presentation, Risk Behaviors, Functioning, Child Safety, Caregiver Needs, and Child Strengths) to assess changes in youth functioning post-discharge (90 and 180 days). An analysis using generalized estimating equations (GEE), controlling for potential confounding variables such as demographics and clinical features, suggest that length of stay in ESFT-FBMHS was significantly associated with out-of-home placement and youth improvement on the CANS at both 90- and 180-days post-discharge. As a group, youth with SED who did not complete the full duration of the program had 2–3 times the odds of out-of-home placement at 90 days post-discharge and 1–3 times the odds at 180 days post-discharge as compared to program completers. CANS scores showed improvement in 40.1% of youth who completed the program as compared to only 11.7%–18.2% for those who did not. The results of this study suggest that ESFT-FBMHS is effective for youth with SED as a group and can improve youth functioning and reduce out-of-home placement.
期刊介绍:
Journal of Child and Family Studies (JCFS) international, peer-reviewed forum for topical issues pertaining to the behavioral health and well-being of children, adolescents, and their families. Interdisciplinary and ecological in approach, the journal focuses on individual, family, and community contexts that influence child, youth, and family well-being and translates research results into practical applications for providers, program implementers, and policymakers. Original papers address applied and translational research, program evaluation, service delivery, and policy matters that affect child, youth, and family well-being. Topic areas include but are not limited to: enhancing child, youth/young adult, parent, caregiver, and/or family functioning; prevention and intervention related to social, emotional, or behavioral functioning in children, youth, and families; cumulative effects of risk and protective factors on behavioral health, development, and well-being; the effects both of exposure to adverse childhood events and assets/protective factors; child abuse and neglect, housing instability and homelessness, and related ecological factors influencing child and family outcomes.