Abstract

Psychiatric rehospitalization is estimated to fall between 30% and 50% among children and adolescents and is said to be the result of complex relationships between clinical and non-clinical child, family and service system factors. Psychiatric rehospitalization has been noted as an unfavorable outcome of inpatient treatment because of the associated economic to society and the family and emotional costs to the family and patient. Therefore, several attempts have been made in the relevant literature to identify and understand factors that will reduce the risk of rehospitalization in this population. In the context of parent professional collaboration, clinician beliefs and family involvement have been indicated as important aspects of treatment among children and youth. To better understand how clinician beliefs and family involvement in treatment influence psychiatric rehospitalization, a prospective study was conducted across four phases on the child and adolescent inpatient units at a large psychiatric facility in Southern California. Data was collected from parents (N=167) of hospitalized children (ages 8-13) and adolescents (ages 14-17) and from a multidisciplinary psychiatric clinical team (N=27). Study findings indicated that neither clinician beliefs nor parent participation in inpatient activities significantly predicted psychiatric rehospitalization. Parent perceptions of empowering behaviors on the part of clinicians, previous hospitalization and psychosocial risk significantly predicted psychiatric rehospitalization. Clinician beliefs did not moderate the relationship between empowering clinician behaviors and psychiatric rehospitalization. Additionally, nearly one-quarter of the children were rehospitalized within 90 days of discharge. Most of the children rehospitalized within the intervening period, were previously hospitalized, had 1 to 2 psychosocial risk factors, longer lengths of stay and were diagnosed with an internalizing disorder. The findings presented may be used to inform research, practice and policies aimed at improving mental health outcomes for children and adolescents with severe emotional and behavioral disorders.

LLU Discipline

Social Policy and Social Research

Department

Social Work and Social Ecology

School

School of Science and Technology

First Advisor

James, Sigrid

Second Advisor

Ball, Lauren

Third Advisor

Distelberg, Brian

Fourth Advisor

Freeman, Kimberly

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

January 2011

Date (Title Page)

9-1-2011

Language

English

Library of Congress/MESH Subject Headings

Mental Disorders - In adolescence; Mental Disorders - In infancy & childhood; Child Psychiatry; Adolescent Psychiatry; Psychotherapy - In adolescence;

Subject - Local

Psychiatric Rehospitalization; Children; Adolescents; Parent Professional Collaboration; Clinician Beliefs; Multidisciplinary Psychiatric Clinical Team; Inpatient activities

Type

Dissertation

Digital Format

Application/PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses & Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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