Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T07:47:02.464Z Has data issue: false hasContentIssue false

Evolve Therapeutic Services: Outcomes for Children and Young People in Out-of-Home Care with Complex Behavioural and Mental Health Problems

Published online by Cambridge University Press:  24 October 2017

Kathryn Eadie*
Affiliation:
Evolve Therapeutic Services, Child and Youth Mental Health Services, Children's Health Queensland Hospital and Health Service, Enoggera, Queensland, Australia
*
address for correspondence: Kathryn Eadie, Evolve Therapeutic Services, Child and Youth Mental Health Services, Children's Health Queensland Hospital and Health Service, Enoggera, Queensland, Australia. E-mail: kathryn.eadie@health.qld.gov.au

Abstract

This study evaluated Evolve Therapeutic Services, an innovative Queensland, Australian programme employing a trauma-informed collaborative wrap-round model of care in combination with a flexible intervention approach that is individually tailored to children and young people in out-of-home care who present with complex and extreme behavioural and mental health problems. The sample consisted of 768 children and young people. Three measures, the Children's Global Assessment Scale, Health of the Nation Outcome Scales for Children and Adolescents and the Strengths and Difficulties Questionnaire were used to assess functioning via a pre-post treatment design. Outcomes were assessed by comparing pre and post-treatment mean scores using repeated-measures t-tests. For estimates of differences in the proportion of children and young people in the clinical range between pre and post-treatment the McNemar test was used. In addition, surveys were completed by carers and stakeholders. Results provided a demographic profile, clinical profile and pre and post-treatment comparisons. Results revealed significant improvements across a range of problem areas: general functioning and adjustment; antisocial behaviour; overactivity and poor attention; non-accidental self-injury; problems with scholastic and language skills; emotional symptoms; peer and family relationships; self-care and independence; and school attendance. Survey data supported the outcomes from the stakeholder-rated and carer-rated measures. Findings provide ongoing evidence for the effectiveness of the therapeutic intervention programme.

Type
Articles
Copyright
Copyright © The Author(s) 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arvidson, J., Kinniburgh, K., Howard, K., Spinazzola, J., Strothers, H., Evans, M., . . . Blaustein, M. E. (2011). Treatment of complex trauma in young children: Developmental and cultural considerations in application of the ARC intervention model. Journal of Child & Adolescent Trauma, 4 (1), 3451.Google Scholar
Australian Mental Health Outcomes and Classification Network (AMHOCN). (2005). Strengths and difficulties questionnaire training manual. Commonwealth of Australia. Retrieved from http://amhocn.org/static/files/assets/d666a3f8/SDQ_Manual.pdf.Google Scholar
Australian Mental Health Outcomes and Classification Network. (2015). Mental health national outcomes and casemix collection: Technical specification of state and territory reporting requirements. Canberra: Australian Mental Health Outcomes and Classification Network.Google Scholar
Bellamy, J., Gopalan, G., & Traube, D. (2010). A national study of the impact of outpatient mental health services for children in long-term foster care. Clinical Child Psychology and Psychiatry, 15 (4), 467479.Google Scholar
Bilenberg, N. (2003). Health of the nation outcome scales for children and adolescents (HoNOSCA). Results of a Danish field trial. European Child & Adolescent Psychiatry, 12 (6), 298302.Google Scholar
Bird, H. R., Yager, T. J., Staghezza, B., Gould, M. S., Canino, G., & Rubio Stipec, M. (1990). Impairment in the epidemiological measurement of childhood psychopathology in the community. Journal of the American Academy of Child and Adolescent Psychiatry, 29 (5), 796803.Google Scholar
Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., . . . Ernst, V. (2001). The trauma symptom checklist for young children (TSCYC) Reliability and association with abuse exposure in a multi-site study. Child Abuse and Neglect, 25 (8), 10011014.Google Scholar
Cantos, A. L., & Gries, L. T. (2010). Therapy outcome with children in foster care: A longitudinal study. Child and Adolescent Social Work Journal, 27 (2), 133149.Google Scholar
Courtney, M. E. (2000). Managed care and child welfare services: What are the issues? Children and Youth Services Review, 22 (2), 8791.Google Scholar
Crime and Misconduct Commission (CMC). (2004). Protecting children: An inquiry into abuse of children in foster care. Brisbane: CMC.Google Scholar
Darlington, Y., Feeney, J. A., & Rixon, K. (2005). Interagency collaboration between child protection and mental health services: Practices, attitudes and barriers. Child Abuse & Neglect, 29 (10), 10851098.Google Scholar
Department of Communities. (2012). Evolve interagency services manual Version 1. Brisbane: Department of Communities.Google Scholar
Frederico, M., Jackson, A., & Black, C. (2010). Take two – third evaluation report. Melbourne: La Trobe University.Google Scholar
Garralda, M. E., Yates, P., & Higginson, I. (2000). Child and adolescent mental health service use. HoNOSCA as an outcome measure. British Journal of Psychiatry, 177 (1), 5258.Google Scholar
Golding, K. (2010). Multi-agency and specialist working to meet the mental health needs of children in care and adoption. Clinical Child Psychology and Psychiatry, 15 (4), 573587.Google Scholar
Goodman, R. (1999). The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40 (5), 791798.CrossRefGoogle ScholarPubMed
Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40 (11), 13371345.Google Scholar
Goodman, R., Ford, T., Corbin, T., & Meltzer, H. (2004). Using the strengths and difficulties questionnaire (SDQ) to screen looked after children for psychiatric disorders. European Child and Adolescent Psychiatry, 13 (Suppl. 2), 11251131.Google Scholar
Gowers, S. G., Harrington, R. C., Whitton, A., Lelliott, P., Wing, J., Beevor, A., & Jezzard, R. (1999). Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the nation outcome scales for children and adolescents (HoNOSCA). British Journal of Psychiatry, 174 (5), 413416.CrossRefGoogle ScholarPubMed
Hawes, D. J., & Dadds, M. R. (2004). Australian data and psychometric properties of the Strengths and Difficulties Questionnaire. Australian and New Zealand Journal of Psychiatry, 38 (8), 644651.CrossRefGoogle ScholarPubMed
Johnson, E., Mellor, D., & Brann, P. (2009). Factors associated with dropout and diagnosis in child and adolescent mental health services. Australian and New Zealand Journal of Psychiatry, 43 (5), 431437.CrossRefGoogle ScholarPubMed
Klag, S., Fox, T., Martin, G., Eadie, K., Bergh, W., Keegan, F., . . . Raeburn, N. (2016). Evolve therapeutic services: A 5-year outcome study of children and young people in out-of-home care with complex and extreme behavioural and mental health problems. Children and Youth Services Review, 69 (C), 268274.Google Scholar
Leve, L. D., Harold, G. T., Chamberlain, P., Landsverk, J. A., Fisher, P. A., & Vostanis, P. (2012). Practitioner review: Children in foster care – vulnerabilities and evidence-based interventions that promote resilience processes. Journal of Child Psychology and Psychiatry, 53 (12), 11971211.Google Scholar
Nathanson, D., & Tzioumi, D. (2007). Health needs of Australian children living in out of home care. Journal of Paediatric Child Health, 43 (10), 695699.Google Scholar
Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9 (11).Google Scholar
Osborn, A., & Bromfield, L. (2007). Young people leaving care (Research Brief No. 7). Melbourne: Australian Institute of Family Studies.Google Scholar
Osborn, A., Delfabbro, P., & Barber, J.G. (2008). The psychosocial functioning and family background of children experiencing significant placement instability in Australian out-of-home care. Children and Youth Services Review, 30 (8), 847860.Google Scholar
Oswald, S. H., Heil, K., & Goldbeck, L. (2010). History of maltreatment and mental health problems in foster children: A review of the literature. Journal of Paediatric Psychology, 35 (5), 462472.Google Scholar
Paxman, M., Tully, L., Burke, S., & Watson, J. (2014). Pathways of care: Longitudinal study on children and young people in out-of-home care in New South Wales. Family Matters, 94, 1528.Google Scholar
Queensland Government. (2009). Pilot study of the routine collection and reporting of information on consumer perceptions of care in Queensland. Brisbane: Queensland Government.Google Scholar
Raghavan, R., Inoue, M., Ettner, S. L., Hamilton, B. H., & Landsverk, J. (2010). A preliminary analysis of the receipt of mental health services consistent with national standards among children in the child welfare system. American Journal of Public Health, 100 (4), 742749.Google Scholar
Richardson, N. (2005). Social costs: The effects of child maltreatment (Resource Sheet No. 9). Retrieved from http://www.aifs.gov.au/nch/pubs/sheets/rs9/rs9.html.Google Scholar
Riley, S. E., Stromberg, A. J., & Clark, J. (2005). Assessing parental satisfaction with children's mental health services with the Youth Services Survey for Families. Journal of Child and Family Studies, 14 (1), 8799.Google Scholar
Sawyer, M. G., Carbone, J. A., Searle, A. K., & Robinson, P. (2007). The mental health and wellbeing of children and adolescents in home-based foster care. Medical Journal of Australia, 186 (4), 181184.Google Scholar
Schneider, S. J., Grilli, S. F., & Schneider, J. R. (2013). Evidence-based treatments for traumatized children and adolescents. Current Psychiatry Reports, 15 (1), 19.Google Scholar
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A children's global assessment scale (CGAS). Archives of General Psychiatry, 40 (11), 12281231.CrossRefGoogle ScholarPubMed
State of Victoria Department of Human Services. (2005). Review of the 2003–2004 Victorian surveys of consumer and carer experience of public mental health services. Melbourne: State of Victoria Department of Human Services.Google Scholar
Steinhausen, H. C. (1987). Global assessment of child psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 26 (2), 203206.Google Scholar
Swenson, C. C., Schaeffer, C. M., Henggeler, S. W., Faldowski, R., & Mayhew, A. M. (2010). Multisystemic therapy for child abuse and neglect: A randomised effectiveness trial. Journal of Family Psychology, 24 (4), 497507.Google Scholar
Tarren-Sweeney, M. (2008). The mental health of children in out-of-home care. Current Opinion in Psychiatry, 21 (4), 345349.Google Scholar
Tarren-Sweeney, M. (2010). It's time to re-think mental health services for children in care, and those adopted from care. Clinical Child Psychology and Psychiatry, 15 (4), 613626.Google Scholar
Tilbury, C., Osmond, J., Wilson, S., & Clark, J. (2007). Good practice in child protection. Frenchs Forest: Pearson Education Australia.Google Scholar
Westermark, P. K., Hansson, K., & Olsson, M. (2011). Multidimensional treatment foster care (MTFC): Results from an independent replication. Journal of Family Therapy, 33 (1), 2041.Google Scholar
Whyte, S., & Campbell, A. (2008). The strengths and difficulties questionnaire: A useful screening tool to identify mental health strengths and needs in looked after children and inform care plans at looked after children reviews? Child Care in Practice, 14 (2), 193206.Google Scholar
Zubrick, S. R., Lawrence, D. M., De Maio, J. A., & Biddle, N. (2004). Testing the reliability of a measure of Aboriginal children's mental health: An analysis based on the Western Australian aboriginal child health survey. Canberra: Australian Bureau of Statistics.Google Scholar