ABSTRACT
OBJECTIVE: To use process evaluation methods to describe the development of a hospital-based mental health clinic for children facing medical stressors. METHODS: Over a 21-month time period, we collected data regarding presenting concern, service use, and referral source using hospital administrative, clinic intake, and clinical records for 356 children. RESULTS: Nearly 90% of the children were referred to the clinic from sources within the hospital. With the exception of single session interventions, there were no differences in average length of services according to presenting concern. Hospital pediatric specialists and psychology consultants were the primary referrers to the program. Pediatric specialists referred more often for procedural concerns and chronic illness than other hospital referrers. CONCLUSIONS: These findings support the feasibility and usefulness of a process evaluation approach in shaping clinical program directions, creating opportunities for collaboration with medical providers, and planning effectiveness research.
Subject(s)
Adaptation, Psychological , Child Guidance Clinics , Outpatient Clinics, Hospital , Process Assessment, Health Care , Child , Child Guidance Clinics/standards , Disease/psychology , Evaluation Studies as Topic , Humans , Referral and Consultation , Research Design , United StatesABSTRACT
As the delivery and reimbursement methods for mental health services change rapidly, measuring treatment outcome and client satisfaction has become critical. This article describes a case example of a treatment outcome and client satisfaction assessment program at the Children's Health Council, a private nonprofit agency affiliated with Stanford University that provides comprehensive mental health services to children and families in Palo Alto, California. Approximately 300 families receive mental health treatment per year at the agency. The simple and inexpensive program presented herein can be used and modified by other mental health professionals and agencies struggling to develop satisfactory treatment outcome and client satisfaction evaluation programs.
Subject(s)
Child Guidance Clinics/standards , Mental Health Services/standards , Outcome Assessment, Health Care , Patient Satisfaction/statistics & numerical data , Adolescent , California , Child , Demography , Family , Humans , Program Evaluation , Quality of Health Care , Surveys and QuestionnairesABSTRACT
In 1982, Jane Knitzer's Unclaimed Children described continued nationwide failure to provide services for children and adolescents with serious emotional disturbances. Since 1982, there has been considerable change in the philosophy, administration, and operation of services for this population. The current study compared state child and adolescent (C/A) mental health systems to those described in Unclaimed Children. Present findings are based on surveys of State Mental Health Representatives for Children and Youth in 1988/89 and 1993. Results indicated a marked increase in the number of state administrative offices and staff for C/A mental health. Much pertinent legislation had been passed. States developed a target population definition and largely officially embraced the Child and Adolescent Services System Program (CASSP) principles of an ideal system of care. Out-of-state placements were high, and placements on adult wards still existed. Counts of these placements were often unavailable to mental health officials.
Subject(s)
Child Guidance Clinics/standards , Mental Health Services/standards , Public Health Administration/standards , Adolescent , Child , Child Guidance Clinics/statistics & numerical data , Data Collection , Humans , Legislation, Medical , Mental Health Services/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Program Evaluation/statistics & numerical data , Role , United StatesABSTRACT
Treatment plans for children in residential centers are required for accreditation and reimbursement, and they can provide important insights to the quality of care. One residential center has developed a system for reviewing treatment plans as part of its quality assurance (QA) monitoring. QA staff use checklists to review plans to assure that they are complete and technically correct and to evaluate the quality and appropriateness of care as revealed in the treatment strategy.
Subject(s)
Child Guidance Clinics/standards , Community Mental Health Centers/standards , Mental Disorders/therapy , Patient Care Planning/standards , Quality Assurance, Health Care/methods , Adolescent , Concurrent Review , Humans , Infant , New York , Quality of Health CareABSTRACT
Fifty-two household interviews were held with families who had self-terminated from a child guidance center. The purpose of these interviews was to determine reasons for self-termination and to measure the effectiveness of the center's program. Findings indicate that the most common reason for self-termination was (1) parents' expectations of therapy were not fulfilled, (2) general dissatisfaction with services, and (3) lack of progress. However, many of the self-terminators rated the center program highly and therefore it was concluded that many self-terminators do not actually reject psychotherapy. Inferences about the causes of self-termination and its alleviation are made.
