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Biomedical subjects

D Papineau

Publications and source records attributed to D Papineau.

8 recordsLinked to original sources

Predicting outcome in a multimodal day treatment program for children with severe behaviour problems.

The demand for day treatment programs for children with severe behaviour problems has greatly increased in the past decade. The objective of this study is to identify characteristics of children who benefit most from such a program. The sample consisted of 63 children, aged five to 13, assessed at admission and discharge from the program. Outcome measures included behavioural improvement and school reintegration. At admission, multivariate analyses revealed that children who made the greatest behavioural improvements had less severe behaviour problems, lower IQ scores and more disturbed family functioning. Children reintegrated into regular classes after discharge were younger at admission, had better reading skills, no attention deficit hyperactivity disorder and little parental marital discord. Findings suggest that successful outcome can be predicted from characteristics of children at intake. A multimodal approach is needed to address the different problems areas in a child's life.

Adolescent↗

Effectiveness of a multimodal day treatment program for children with disruptive behavior problems.

OBJECTIVE: Children with disruptive behavior disorders are often also dysfunctional in academics, social skills, and self-esteem. The efficacy of multimodal day treatment in addressing these deficits was evaluated. METHOD: Thirty children, assigned to day treatment or a waiting list, were compared on measures of behavior, self-perception, academics, peer relations, and family functioning. RESULTS: Multivariate analyses of covariance showed that the treatment group improved significantly more on measures of behavior and self-perception. Six-month follow-up findings indicate that treated children had improved over time on all measures except academics. CONCLUSIONS: This study demonstrates that compared with a waiting list control group, day treatment produces greater gains, and that these gains are maintained at 6 months' follow-up. It also shows the need for a treatment that combines multiple modalities in dealing with children with disruptive behavior disorders.

Achievement↗

A comparison of day treatment and outpatient treatment for children with disruptive behaviour problems.

The authors explored the relative merits of outpatient and day treatment for 30 children with severe behaviour problems. The effectiveness of treatment on behaviour, self-perception, and social and family functioning was assessed. Day treatment was found to be more effective in reducing behaviour problems, alleviating depressive symptoms, increasing social skills and improving family functioning.

Ambulatory Care↗

A comparison of the cost-effectiveness of day treatment and residential treatment for children with severe behaviour problems.

This study compares the cost of treating 23 children admitted to a residential treatment unit in a psychiatric hospital and 23 children admitted to the same unit after it was converted to a day treatment program, through a retrospective chart review. The two groups were similar in age, gender, diagnosis, severity of pathology, family functioning and support, the number of subjects who dropped-out, and treatment outcome. The average length of stay on the unit dropped from 19.6 to 6.1 months, and the average cost of treatment per child decreased from $61,412 to $9,213 (Canadian dollars, adjusted for inflation). The sharp decrease in treatment time with day treatment may be the result of close links with community schools and maintaining the child in the family and community. The cost savings can be attributed to the shorter hospital stays and the lower operating costs of day treatment. Implications of these findings will be discussed with respect to health care policy including the need to raise awareness of day treatment as a cost-effective alternative to residential hospital treatment.

Adolescent↗

Economic constraints and quality assurance in mental health services: sensitive indicators.

Clinicians in the field of mental health are met with the dual challenge of increased accountability and shrinking resources. Funds are often allocated through the use of crude administrative monitors. This is of little solace to the clinician faced with unmet patients' wants and needs. A set of clinical monitors is outlined requiring the practitioner's cooperation. The presentation of an accurate composite picture is a must in the process of resource allocation. Such clinical monitors include the analysis of characteristics of patients such as the repeaters at emergency, "the revolving door" pool of patients and those falling in between networks. Reviews of waiting lists and lengths of stay, an evaluation of nursing care variables, the auditing of the choice of therapeutic modalities and the use of restraints are other suggested contributors to the assessment of service needs.

Canada↗