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Presented at the 19th Annual Research Conference

Getting it Right: Learning from Intensive Home-Based Treatment Responders and Non-Responders

We're sorry, handouts are not available for this presentation.

Session Number: 52 Room: Salon I

Presentation Type: symposium

Chair: Katherine E. Grimes Discussant: Robert Friedman

Synopsis: This symposium challenges the treatment and evaluation community for youth with serious emotional disturbance, to investigate home and community-based treatment effects and improve knowledge regarding use. Multisystemic Therapy (MST) has pioneered detailed evaluations of both those youth who are responders to MST and those who are not. Mental Health Services Program for Youth has begun a similar effort, hoping that a closer look at responders and non-responders will lead to improvement of the evidence base within systems of care. The three papers approach this need differently, but share the goal of better specificity and effectiveness when selecting intensive home and community based treatment for vulnerable youth.

Date: Friday, February 24, 2006

Session Time: 2:30 PM - 3:30 PM

Presentation Time: 2:30 PM - 3:30 PM

Multisystemic Therapy as an Alternative to Hospitalization: Follow-Up Suicidality Outcomes

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Presenting: Stanley Huey, Jr.

All Authors for this paper: Stanley Huey, Jr.; Melisa Rowland

Presentation Type: element of symposium

Synopsis: Objective: To describe findings on suicidal ideation/behavior from a randomized trial comparing MST and hospitalization. Method: In Study 1, suicide attempts, ideation, affect, and parental control were assessed. In Study 2, responders and non-responders were compared to evaluate the contribution of risk factors and establish odds ratios for predicting treatment response. Results: Multisystemic Therapy (MST) was more effective at decreasing rates of attempted suicide at 1-year follow-up by youth report. In study 2, depressive affect and parental control predicted non-response. Conclusions: Study 1 suggests that MST is effective in addressing suicidal behavior in this population. Study 2 provides information concerning potentially useful modifications.

Youths Presenting in Psychiatric Crisis: A Closer Look at Responders and Non-Responders

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Presenting: Melisa Rowland

All Authors for this paper: Melisa Rowland; Colleen Halliday-Boykins; Colleen Halliday-Boykins

Presentation Type: element of symposium

Synopsis: Objective: To describe symptom trajectories following psychiatric crisis and to examine the psychosocial correlates and placement outcomes associated with identified trajectories. Method: Using semi-parametric mixture modeling with 156 youths approved for psychiatric hospitalization, five trajectories were identified based on symptoms over 16 months following crisis. Results: Membership in unimproved symptom groups was associated with less suicidality, younger age, more youth hopelessness and more caregiver empowerment. Improved symptom group membership predicted long-term decreases in out-of-home placements. Conclusion: A substantial proportion of youths sustained high levels of symptomatology despite intensive services. Implications of these findings for serving youth with serious emotional disturbances will be discussed.

Differential Effectiveness: A Closer Look at Home-Based Treatment Responders

Download Handouts: 558kb pdf

Presenting: Katherine Grimes

All Authors for this paper: Katherine Grimes; Brian Mullin; Brian Mullin

Presentation Type: element of symposium

Synopsis: The Mental Health Services Program for Youth (MHSPY) uses a multi-source, family-driven, assessment of mission achievement that determines whether an individual youth is ready to "graduate" from the program. A review of MHSPY graduates versus non-graduates revealed a surprising five-fold difference in Child and Adolescent Functional Assessment Scale (CAFAS) score percent improvement for graduates, although CAFAS change was not a criterion for graduation. This paper summarizes the findings from a subsequent investigation of sample characteristics for MHSPY "graduates" vs. non-graduates. Detailed comparisons of demographics, family risk factors, diagnoses and treatment exposure have been undertaken to identify contributing variables which may predict responsiveness to home-based treatment.