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

IF 1.6 3区 心理学 Q2 FAMILY STUDIES
C. Wayne Jones, Steve Simms, Jesse Troy, Scott Suhring, Dan Warner, Tara Byers
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引用次数: 0

摘要

本研究的主要目的是评估宾夕法尼亚州针对有严重情绪障碍(SED)的青少年所开展的全州范围的强化居家治疗--生态系统结构家庭疗法--基于家庭的心理健康服务(ESFT-FBMHS)的有效性。尽管该项目实施已久,但经验评估仍然不足。在这项档案研究中,我们对四级住院时间的家庭外安置和青少年功能结果进行了比较。鉴于 ESFT-FBMHS 的治疗对象为高风险人群,我们假设完成整个疗程(169-224 天)的家庭和青少年会比那些在 168 天或更短时间内停止治疗的家庭和青少年有更好的疗效。我们采用事后定量研究设计,分析了 2018 年至 2022 年期间接受治疗的 2251 名青少年的存档医疗索赔数据,以评估家庭外安置率,并分析了儿童和青少年需求与优势(CANS;问题表现、风险行为、功能、儿童安全、照顾者需求和儿童优势)六个领域的存档数据,以评估青少年出院后(90 天和 180 天)的功能变化。使用广义估计方程(GEE)进行的分析表明,在出院后90天和180天内,ESFT-FBMHS的住院时间与家庭外安置和青少年CANS的改善有显著关系。作为一个群体,未完成整个项目的 SED 青少年在出院后 90 天的家庭外安置几率是完成项目者的 2-3 倍,在出院后 180 天的家庭外安置几率是完成项目者的 1-3 倍。在完成计划的青少年中,有 40.1%的人 CANS 分数有所提高,而未完成计划的青少年只有 11.7%-18.2%。这项研究结果表明,ESFT-FBMHS 对患有 SED 的青少年群体是有效的,可以改善青少年的功能,减少家庭外安置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
CiteScore
3.60
自引率
4.80%
发文量
300
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.
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