Abstract

Recent studies of adult mental health treatment have used patient-focused research methods to improve outcomes, by tracking treatment response and comparing it with expected recovery patterns. One such line of research has used rationally-derived and empirically-derived methods to analyze data gathered by the OQ-45 and identify patients who are not responding as expected to treatment. This allows for adjustment of treatment, which results in improved outcomes and lower overall costs.

Similar but less extensive research has provided evidence that these approaches may also improve outcomes in outpatient treatment for children and adolescents. These approaches might be particularly useful in residential treatment settings, which are one of the more risky and expensive forms of treatment for this population, but the research on this is minimal. This study evaluated the ability of a relatively well-researched rationally-derived method to predict treatment failure on the basis of YOQ scores for children and adolescents in residential treatment.

Of particular interest was the ability of this method to identify which residents were at the greatest risk of not responding to or worsening from residential treatment. The purpose of early identification is to provide an opportunity to improve or change the treatment approach for those who are not benefiting, and to identify as soon as possible residents who have improved adequately and are no longer in need of residential treatment.

It was found that this method predicted treatment failure at above chance levels of accuracy, with minimal false negatives. This method was particularly accurate in its predictions for those at the negative polarity of treatment outcome. Patients who were identified by this method as potential treatment failures were significantly (p < .001) more likely to have a negative treatment outcome than patients who were not identified.

This study provides evidence that the rationally-derived method would likely be useful in a residential treatment setting, to help optimize use of the limited available funding by predicting which patients are at the greatest risk of failing or not responding to treatment, as well as by identifying patients who have responded appropriately to treatment and are ready for discharge.

LLU Discipline

Experimental Psychology

Department

Psychology

School

Graduate School

First Advisor

David A. Vermeersch

Second Advisor

Kendal Boyd

Third Advisor

Jason E. Owen

Degree Name

Master of Arts (MA)

Degree Level

M.A.

Year Degree Awarded

2009

Date (Title Page)

6-2009

Language

English

Library of Congress/MESH Subject Headings

Residential Treatment; Psychotherapy -- methods; Patient Participation -- psychology; Evidence-Based Practice; Treatment Failure; Data Collection; Program Evalpic; Analysis of Variance; Outcomeuation -- methods; Evaluation Studies as To and Process Assessment (Health Care)

Type

Thesis

Page Count

xi; 85

Digital Format

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 and Dissertations

Collection Website

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

Repository

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

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