Abstract
In two German child and adolescent psychiatric treatment and research centers, a controlled treatment study was conducted in which two randomized treatment groups (in-patient treatment and home treatment) were compared. Subjects were children and adolescents with severe psychiatric disorders, for whom normal outpatient treatment was not sufficient (mean age of the patients was 11 years and 9 months at the beginning of treatment). The results showed no differences in therapy outcome between the two treatment modalities. In a further study, the results of which are presented here, a follow-up assessment (average follow-up interval: 3 years and 8 months) of the two treatment groups (follow-up sample of the inpatient treatment group: n=33; home treatment group: n=35) was untertaken in order to investigate the course of the psychiatric disturbances and the long-term effects of the treatments. As measurement categories for the outcome “adaption at school” and “number of marked symptoms” were used in pre-, post- and follow-up assessment. The most important results are 1) The number of marked psychiatric symptoms and the adaptation at school or work exhibit the same type of course over time. Post-treatment scores are much better when compared to pre-treatment scores, but decline slightly upon follow-up, although they remain significantly better than the pre-treatment scores. Thus, the study shows that improvements relating to the psychiatric symptoms are quite stable after several years. 2) There were no relevant differences between the treatment modalities “inpatient treatment” and “home treatment” in terms of effect-size upon follow-up, and in inferential analysis. Any tendency towards difference was in favor of home treatment. So the results give strong support to the conclusion that at least for a specific group of patients (about 15% of those patients usually treated in an inpatient setting) residential treatment can be replaced by home treatment and that the long-term therapeutic outcome of home treatment is stable and persistent. Thus, in terms of psychiatric care and clinical practice, our results provide empirical support to the idea that home treatment should be used more frequently and much more broadly in the future.
Similar content being viewed by others
References
Angold A, Costello Ej, Burns B, Erkanli A, Farmer EMZ (2000) Effectiveness of nonresidential specialty mental health services for children and adolescents in the “real world”. Journal of the American Academy Child and Adolescent Psychiatry 39: 154–160
Brandenbusch A (1995) Die Marburger Symptomliste. Eine Untersuchung zur Beurteilerübereinstimmung. Diplomarbeit im Fachbereich Psychologie der Philipps-Universität. Marburg
Cytel Software Corporation (1996) LogXact for Windows. CYTEL Software Corporation, ISBN No. 0.9624108-9-6. Cambridge, MA
Göpel C, Schmidt MH, Blanz B, Rettig B (1996) Behandlung hyperkinetischer Kinder im häuslichen Milieu. Zeitschrift für Kinder- und Jugendpsychiatrie 24: 192–202
Henggeler SW, Pickrel SG, Brondino MJ, Crouch JL (1996) Eliminating (almost) treatment dropout of substance abusing or dependent delinquents through homebased multisystemic therapy. American Journal of Psychiatry 153: 427–428
Henggeler SW, Rowland MD, Randall J, Ward DM, Pickrel SG, Cunningham PB, Miller SL, Edwards J, Zealberg JJ, Hand LD, Santos AB (1999) Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry 38: 1331–1339
Hirt BR (1993) Der Langzeiteffekt von teilstationärer Behandlung und Behandlung im häuslichen Milieu (Hometreatment). Med Diss Univ Heidelberg
Lay B, Blanz B, Schmidt MH (2001) Effectiveness of home treatment in children and adolescents with externalizing psychiatric disorders. European Child & Adolescent Psychiatry. Supplement (this issue)
Kydd RR, Werry JS (1982) Schizophrenia in children under 16 Years. Journal of Autism and Childhood Disorders 12: 343
Mattejat F, Remschmidt H (1993) Die Marburger Symptomliste. Arbeiten aus der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters der Philipps-Universität, 2. überarb. Aufl., Marburg
Ozonoff S, Cathcart K (1998) Effectiveness of a home program intervention for young children with autism. Journal of Autism and Developmental Disorders 28: 25–32
Remschmidt H, Schmidt MH (eds) (1985) Therapieevaluation in der Kinder- und Jugendpsychiatrie (pp. 46–69). Enke, Stuttgart
Remschmidt H, Schmidt MH (1988) Alternative Behandlungsformen in der Kinder- und Jugendpsychiatrie. Stuttgart, Enke
Remschmidt H, Schmidt MH, Mattejat F, Eisert HG, Eisert M (1988) Therapieevaluation in der Kinder- und Jugendpsychiatrie: Stationäre Behandlung, tagesklinische Behandlung und Home treatment im Vergleich. Zeitschrift für Kinder- und Jugendpsychiatrie 16: 124–134
Rosenthal R (1991) Meta-analytic Procedures for the Social Research. Sage Publ. London
Wilken J (1992) Therapieerfolg und Langzeitverlauf. Katamnestische Untersuchung einer evaluierten kinder- und jugendpsychiatrischen Stichprobe. Med Diss Universität Marburg
Winsberg BG, Bialer I, Kupietz S, Botti E, Balka EB (1980) Home vs hospital care of children with behavior disorders. Archives of General Psychiatry 37: 413–418
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mattejat, F., Hirt, B.R., Wilken, J. et al. Efficacy of inpatient and home treatment in psychiatrically disturbed children and adolescents. European Child & Adolescent Psychiatry 10 (Suppl 1), S71–S79 (2001). https://doi.org/10.1007/s007870170008
Issue Date:
DOI: https://doi.org/10.1007/s007870170008