ARTICLES
Outcome and Follow-up Study of an Adolescent Psychiatric Day Treatment School Program

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ABSTRACT

Objectives

To evaluate outcome and follow-up of 55 subjects who attended a classroom-based, adolescent psychiatric day treatment unit school program (ADTU) situated in a community high school by examining pre-post changes in emotional, behavioral, family, and academic functioning and to identify preadmission and family variables associated with outcome.

Method

Student-patients were assessed on clinical/academic variables at admission, discharge, and follow-up, using standardized assessment measures. Patient satisfaction was also evaluated.

Results

Significant improvements in emotional-behavioral and academic functioning were found at discharge and follow-up. Hierarchical regression analysis revealed that parent and clinician ratings at admission, total number of separations from family greater than 3 months, parental history of mental illness, and patient history of treatment for emotional problems were significantly associated with outcome. Satisfaction questionnaires revealed a high degree of satisfaction with the program.

Conclusions

The ADTU is a successful treatment program for adolescents with chronic, severe emotional and behavioral disorders, despite limitations of the study.

Section snippets

Purpose

This study evaluated the outcome of adolescents who attended the Adolescent Day Treatment Unit (ADTU), McHugh School Program, of the Regional Children's Mental Health Centre, Royal Ottawa Hospital, a teaching hospital affiliated with the University of Ottawa, located in the Ottawa-Carleton region (Ontario, Canada). We evaluated outcome over a 3-year period by examining pre-post program changes in emotional, behavioral, family, and academic functioning. Other important objectives of the study

Subjects

Subjects consisted of 55 white adolescents (boys, n = 33 or 60%; girls, n = 22 or 40%) between the ages of 12 and 19 years (mean = 14.2, SD = 1.5), consecutively admitted to the ADTU, during the period from September 1993 to June 1996. Student-patients were referred from outpatient units (48%), inpatient units (20%), school boards (30%), and private physicians (2%). The program is provided to adolescents and their families who are experiencing moderate to severe or prolonged emotional,

RESULTS

Of 55 patients who participated, 45 completed the study. DSM-III-R diagnoses at admission were collected from all 55 students entered into the study. Noncompleters were enrolled in the ADTU for less than 3 months and discharged because of unwillingness to participate in treatment. Other data were unavailable for noncompleters because of the short length of stay. Completers and noncompleters differed significantly in the degree of comorbidity (t = 2.1, df = 52, p = .04): noncompleters exhibited

DISCUSSION

In this comprehensive study, adolescents attending a psychiatric, multimodal, long-term day treatment program, similar to those described by Kiser et al. (1995) but unique in its community high school, classroom-based academic model, were assessed at admission, discharge, and follow-up. To our knowledge, this is the only prospective outcome and follow-up study of a day treatment program of an adolescent population. Adolescents, parents, and clinicians reported marked improvements in behavior

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    This study was supported by a grant from the Royal Ottawa Hospital Foundation and University of Ottawa Medical Research Fund.

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    Copyright © 2000 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.