Volk, Donna Susanne (2004) An evaluation of inpatient family treatment in a child psychiatric setting. Other Degree thesis, Victoria University.

Abstract

Child psychiatric treatment currently faces challenges, which centre on accountability regarding treatment effectiveness, which are derived from a range of social, economic and political developments. Identifying effective treatment options for work with multiproblem, treatment resistant families, presents as a significant further challenge. Full family inpatient treatment has been utilised as one unique therapeutic option. To date, few systematic emprical studies have been conducted in the child psychiatry inpatient area to evaluate programmes outcomes, and fewer still concerning family inpatient treatment. No studies have comprehensively integrated process and outcome evaluation. The aim of the present study was to evaluate the outcome and processes of a dedicated, short-term, multi-modal, inpatient family treatment programme. The research comprised two complementary stages, integrating quantitative and qualitative research designs. Stage 1 analysed archival data, comprising standardised measures of the referred child and sibling (Achenbach CBCL) , parent (GHQ-28) and family functioning (McMaster FAD), administered at admission and discharge. The subject sample involved 29 families consecutively admitted to the programme from 1995 to 1997 (LP mean age 8.82 years, range 4-13 years). Stage 2, conducted 30 months later, adopted a retrospective, qualitative approach, using in-depth individual interviews with 10 former clinicians of the programme, exploring their perceptions regarding the programme's theoretical orientation, practices and outcomes. Stage 1 findings clearly indicated improvements in perceived child, parent and family functioning between the time of admission and the time of discharge. The Stage 2 study found that the programme was experienced as operating within a broad-based theoretical orientation with a systemic foundation, drawing on psychodynamic, cognitive-behavioural, and other theoretical principles. The main strengths of the programme emerged in its overall structure and planning, and the holding frame provided by the supportive therapeutic milieu. Potential programme limitations included certain differing agendas between families and the team. The research generated implications for integration of theory in this field and for specific dimensions of practice in intensive, short-term work with treatment resistant multi-problem familes. Implications for outcome and process research methodology are also discussed, with a particular emphasis on exploring mechanisms of therapeutic change.

Search Google Scholar

Repository staff login