Abstract
We examined trajectories of symptom reduction during the course of on-site treatment for behavior problems in pediatric primary-care settings for a subset of children from a larger clinical trial. Participants (N = 80) were children (ages 6–11) referred for treatment due to moderate elevations (≥75th percentile) on the externalizing subscale of the Pediatric Symptom Checklist (PSC-17). The sample was recruited from six pediatric practices in an urban setting. The treatment (Protocol for an Office-based Nurse-administered Intervention; PONI) was administered on-site by trained nurses over the course of 3–6 months. Overall, symptom reduction from the first session to last session was moderate (ES = 0.61) and gradual. Roughly two-thirds (72%) of symptom reduction took place over the first 8 weeks of treatment. The average trajectory of symptom reduction was characterized by a negative slope that flattened over time, consistent with a quadratic growth model. Initial symptom severity predicted final symptom severity (r = .36, P < .01), even though patients with greater initial symptom severity remained in treatment for a significantly greater number of sessions (r = .24, P < .05). The implications of these findings for enhancing the efficiency and effectiveness of treatment are discussed.
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Acknowledgments
This study was supported by a grant to the second author from the National Institute of Mental Health (MH63272) and by a T32 Fellowship to the first author. The authors acknowledge the research and clinical staff of the (Services for Kids in Primary-Care) SKIP program.
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Lindhiem, O., Kolko, D.J. Trajectories of Symptom Reduction During Treatment for Behavior Problems in Pediatric Primary-Care Settings. Adm Policy Ment Health 38, 486–494 (2011). https://doi.org/10.1007/s10488-011-0335-2
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DOI: https://doi.org/10.1007/s10488-011-0335-2