Assessment
of Treatment Outcomes in Outdoor
Behavioral Healthcare
By
Keith C. Russell, Ph.D.
Executive Summary
This publication describes and reports results from a study of client
outcomes in eight participating outdoor behavioral healthcare (OBH)
programs. A pretest-posttest, research design was used to assess 858 out
of 1035 clients (83%) who received OBH treatment from May 1, 2000 to
December 1, 2000. Treatment outcomes were evaluated through client
self-report and parent assessment of adolescent well-being at admission
and discharge utilizing the Youth Outcome Questionnaire (Y-OQ)
(Burlingame, Wells, & Lambert 1995). A subsequent report will present
data from follow-up assessments on the same clients at three-, six-, and
twelve-month periods. Clients were in OBH treatment for an average length
of 38 days.
The clients enrolling in the eight OBH programs during the period of
this study were predominantly male (69%) and between the ages of 16-18
(75%). Clients entered treatment with a variety of disruptive behavioral,
mood and substance disorders as their primary psychiatric diagnoses. Of
the 481 clients for whom data were available on diagnoses, 48% also had a
secondary diagnoses. Most prevalent were those diagnosed with behavioral
disorders (38%), some form of substance abuse or dependence disorder
(30%), and mood disorders (22%). Over half (57%) of the OBH clients had a
history of outpatient treatment, 17 % had utilized inpatient services, and
13% had utilized both types of services prior to OBH treatment.
Client self-report mean Y-OQ scores were 70.67 at admission and
47.55 at discharge, indicating an average score reduction of more than 20
points. Parent assessment Y-OQ mean scores were 101.19 at admission
and 48.55 at discharge, indicating an average reduction of 52.64. Thus,
parents rated the clients presenting symptoms as more severe than did the
clients themselves, but they perceived symptoms at discharge that were
very similar. Discharge scores for both client self report and parent
assessment are close to the normal range of symptoms (46 or below) as
established by Burlingame et al. (1995b) in their sample tests of normal
populations. Client self-reported Y-OQ scores across all ages show similar
reductions from admission to discharge, and with exception of 15-year
olds, showed a trend of increasing score reductions with increasing age
(16 to 18). Parent assessments across all age groups were higher at
admission and showed similar reductions at discharge. Female clients
report higher Y-OQ admission and discharge scores for both client
self-report and parent assessments, and also showed a greater reduction in
scores than males. However, discharge scores for females remained higher
than for males (54.37 and 47.44 respectively).
Results of this study indicate that participation in OBH programs led
to a statistically significant reduction in the severity of behavioral and
emotional symptoms, as perceived by the clients, and even more so by their
parents, as measured by the Y-OQ questionnaire. A majority (55 %) of OBH
clients participating in this study had Y-OQ scores at discharge
compatible with a normal range of symptoms (46 or below) as established by
Burlingame et al. (1995b) in their sample tests of normal populations.
When comparing the results of this study to other outcome studies in the
literature which used the Y-OQ, OBH programs showed greater score
reductions in shorter treatment durations.