Home treatment for children and adolescents with psychiatric disorders.
The study examines the effectiveness of home treatment in 70 children and adolescents (aged 6-17 years) with heterogeneous psychiatric disorders. Home treatment was offered to parents/children as an alternative to inpatient treatment (no randomized group assignment). Interventions were carried out by psychiatric nurses (n = 38) and medical students (n = 32) under the supervision of experienced child psychiatrists. Assessment of treatment effects was based on a structured parent interview and parents', children's and therapists' ratings of various aspects of psychosocial functioning. Pre- or post-treatment comparisons indicate significant improvement of psychiatric symptoms, severity of the disorder, and psychosocial adjustment after three months of home-based interventions. Outcome of behavioral interventions carried out by experienced nurses was superior, compared to treatment effects achieved by advanced medical students. Post-treatment comparison of home-based (n = 70) and inpatient-based (n = 35) treatment effects suggests that inpatient treatment all in all was more effective. At one-year follow-up, however, the effects of home treatment were maintained in a higher number of patients, compared to the stability of effects seen after psychiatric hospitalization. Thus, home treatment appears to be an effective treatment setting. Motivation and compliance of patient and parents, and high skills of the therapists are key ingredients for the success of a home-based treatment program.
Schmidt
Martin H
MH
Clinic for Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, J5, 68159 Mannheim, Germany. schmidt@zi-mannheim.de
Lay
Barbara
B
Göpel
Christopher
C
Naab
Silke
S
Blanz
Bernd
B
D000293:Adolescent; D002648:Child; D002983:Clinical Competence; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel; D006699:Home Care Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D011584:Psychology; D012720:Severity of Illness Index; D012931:Social Environment; D013997:Time Factors