Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: Clinical outcomes

Author(s): Rowland, M. D., Randall, J., Ward, D. M., Pickrel, S. G., Cunningham, P. B., Miller, S. L., Edwards, J., Zealberg, J. J., Hand, L. D., Santos, A. B.

Journal/Book: J Amer Acad Child Adolesc Psy. 1999; 38: 227 East Washington Sq, Philadelphia, PA 19106, USA. Lippincott Williams & Wilkins. 1331-1339.

Abstract: Objective: The primary purpose of this study was to determine whether multisystemic therapy (MST), modified for use with youths presenting psychiatric emergencies, can serve as a clinically viable alternative to inpatient psychiatric hospitalization. Method: One hundred sixteen children and adolescents approved for emergency psychiatric hospitalization were randomly assigned to home-based MST or inpatient hospitalization. Assessments examining symptomatology, antisocial behavior, self-esteem, family relations, peer relations, school attendance, and consumer satisfaction were conducted at 3 times: within 24 hours of recruitment into the project, shortly after the hospitalized youth was released from the hospital (1-2 weeks after recruitment), and at the completion of MST home-based services (average of 4 months postrecruitment). Results: MST was more effective than emergency hospitalization at decreasing youths' externalizing symptoms and improving their family functioning and school attendance. Hospitalization was more effective than MST at improving youths' self-esteem. Consumer satisfaction scores were higher in the MST condition. Conclusions: The findings support the view that an intensive, well-specified, and empirically supported treatment model, with judicious access to placement, can effectively serve as a family-and community-based alternative to the emergency psychiatric hospitalization of children and adolescents.

Note: Article Henggeler SW, Med Univ S Carolina, Dept Psychiat & Behav Sci, Family Serv Res Ctr, 67 President St, Suite CPP, Box 250861, Charleston,SC 29425 USA

Keyword(s): psychiatric hospitalization; crisis; multisystemic therapy; PAST 10 YEARS; SUBSTANCE-ABUSE; CARE; ADOLESCENTS; CHILDREN; SERVICES; INPATIENT; CHILDHOOD; FAMILY; MODEL

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