ARTICLES
Strengths of Children and Adolescents in Residential Settings: Prevalence and Associations With Psychopathology and Discharge Placement

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ABSTRACT

Objective

During the past few years there has been growing interest in developing strength-based approaches to services, particularly for children and adolescents.

Method

This study assesses the prevalence of 30 strengths for a random sample of children and adolescents in residential placements in Florida. In addition, the relationship between strengths and clinical and functional characteristics is studied.

Results

Results suggest that there is substantial variation across individuals on the presence of strengths and the potential for development. Strengths were associated with symptoms, risk behaviors, and functioning. Level of strengths predicted success in the reduction of risk behaviors during the child/adolescent's stay. In addition, the level of strengths was independently associated with good dispositional outcomes.

Conclusions

The findings provide further empirical support for the importance of strengths and the utility of an integrated model that considers both psychopathology and strengths in planning for children's services.

Section snippets

METHOD

This study was conducted as an aspect of a feasibility study of bundled rate methodology for Medicaid in Florida. Fifteen residential placement sites that bill Medicaid for mental health services were selected for review. A 16th site that expressed interest in billing Medicaid in the future also agreed to participate. At each site, a random sample of 30 children and adolescents were selected from among cases who had received any Medicaid billing for services rendered in the previous year. At

RESULTS

The sample consisted of 450 cases, 123 of which had already been discharged from the residential facility at the time of the review. Of the full sample, 55% were boys and 45% girls. The ages ranged from 5 to 19 years, with an average age of 13.7 years. Nearly half of the sample was white (49%), about one third (35%) was African-American, 11% was Hispanic, and the remaining 5% was made up of Native Americans and Asian/Pacific Islanders.

Table 2 presents the frequency of each level of the 30

DISCUSSION

The findings of this study demonstrate the potential importance of strengths of children and adolescents in the provision of mental health services. There was substantial variation across individuals and across types of strengths. In addition to the notable variation, correlational analyses suggest that strengths may serve an important role in level of functioning and dispositional planning. While the individual's level of strengths was associated with symptoms and risk behaviors, it was also

REFERENCES (38)

  • L Eber et al.

    School-based applications of the wraparound process: early results on service provision and student outcomes

    J Child Fam Stud

    (1996)
  • M Gelkopf et al.

    Is humor only fun, an alternative cure or magic: the cognitive therapeutic potential of humor

    J Cogn Psychother

    (1996)
  • ER Hamlin et al.

    Sibling group treatment

    Clin Soc Work J

    (1994)
  • TF Heatherton et al.

    Personal accounts of successful versus failed attempts at life change

    Pers Soc Psychol Bull

    (1994)
  • JR Ickovics et al.

    Paradigm shift: why a focus on health is important

    J Soc Issues

    (1998)
  • J Knitzer

    Unclaimed Children

    (1982)
  • IS Lourie

    New approaches in mental health services for adolescents

    Clin Psychol

    (1987)
  • SS Luthar et al.

    Vulnerability and competence: a review of research on resilience in childhood

    Am J Orthopsychiatry

    (1991)
  • JS Lyons

    The Severity and Acuity of Psychiatric Illness: Child and Adolescent Version

    (1998)
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    Reviewed under and accepted by Michael S. Jellinek, M.D., Associate Editor.

    The research reported in this article was funded in part by the Florida Agency for Health Care Administration.

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