title: Implementation of effective treatments of preschool behavior problems in a clinic setting.
abstract: Epidemiological data indicate that nearly 20% of preschool aged children have significant behavioral problems. Parents typically consult their child's primary care provider, who frequently refers to child psychologists for treatment regarding these difficulties. Psychologists skilled in providing effective services for young children are in short supply, limiting accessibility, and parents often are reluctant to follow up with a mental health specialist, suggesting low acceptability. The Behavior Consultation Clinic is a structured clinic for preschool children designed to address these issues of effectiveness, accessibility and acceptability. A retrospective review of 550 patients seen over a 5-year period found that half were seen for one therapy session. Review of the remaining patients found that slightly more than half showed improvement (32% successful discharge with improvement, 24% premature discharge with improvement) with a typical range of two to seven half-hour sessions, about a quarter did not improve, and the remaining patients were referred to a higher level of service. These data indicate that a structured, brief clinic that focuses on the needs of preschool children utilizing evidence-based approaches can be effective, acceptable, and accessible. The Behavior Consultation Clinic also serves as a training clinic for psychology interns and pediatric medical residents.
authors.affiliation: Learning Support Center for Child Psychology, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA. meaxelra@texaschildrenshospital.org
authors.forename: Marni E
authors.initials: ME
authors.lastname: Axelrad
authors.forename: Jennifer Shroff
authors.initials: JS
authors.lastname: Pendley
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Miller
authors.forename: W Douglas
authors.initials: WD
authors.lastname: Tynan
mesh_terms: D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000523:psychology / Q000628:therapy*; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States