title: Functional outcomes of maltreated children and adolescents in a community-based rehabilitation program in Brazil: six-month improvement and baseline predictors.
abstract: This study sought to implement outcomes monitoring and to review outcome data from a community-based rehabilitation program for maltreated children and adolescents in São Paulo, Brazil. Maltreated children and adolescents (N=452) were enrolled in The Equilibrium Program (TEP), a multidisciplinary community-based rehabilitation program. About half (n=230) of the participants were successfully evaluated using the Children's Global Assessment Scale (C-GAS) at entry, 3, and/or 6 months later. Analysis of outcomes used hierarchical linear modeling of functional change from baseline. With a baseline C-GAS score of 51.7 (SD=14.22), average improvement was 2.8 and 5.5 points at 3 and 6 months, respectively (reflecting small to moderate effect sizes=0.20 and 0.39). Improvement was associated with Problems related to upbringing (p<.02) at entry and absence of Physical abuse (p<.05) and Negative life events in childhood (p<.05) but was not associated with sociodemographics or any specific psychiatric diagnosis. This study showed that outcomes monitoring is feasible in a community-based program in a developing country. Although there was no untreated control group for comparison and specific evidence-based treatments were not used, it is notable that significant improvement, with small to moderate effect size, was observed.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA New England Mental Illness Research, Education and Clinical Center, Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Elina A
authors.initials: EA
authors.lastname: Stefanovics
authors.affiliation: The Equilibrim Program (TEP), Department and Institute of Psychiatry, Medicine School, University of São Paulo (USP), R.Ovidio Campos Pieres Campos, 785, São Paulo, Brazil.
authors.forename: Mauro V M
authors.initials: MV
authors.lastname: Filho
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA New England Mental Illness Research, Education and Clinical Center, Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
authors.affiliation: The Equilibrim Program (TEP), Department and Institute of Psychiatry, Medicine School, University of São Paulo (USP), R.Ovidio Campos Pieres Campos, 785, São Paulo, Brazil.
authors.forename: Sandra
authors.initials: S
authors.lastname: Scivoletto
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000534:rehabilitation*; D003156:Community Mental Health Services / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Maltreated children; Mental health; Program evaluation system care