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Trauma as a Predictive Indicator of Clinical Outcome in Residential Treatment

NCJ Number
227514
Journal
Residential Treatment for Children & Youth Volume: 26 Issue: 2 Dated: April-June 2009 Pages: 92-104
Author(s)
Susan N. Boyer M.A.; Lauren S. Hallion B.A.; Carrie L. Hammell B.A.; Suzanne Button Ph.D.
Date Published
May 2009
Length
13 pages
Annotation
This study identified predictors of residential treatment outcome for youth, using data collected and analyzed on multiple variables.
Abstract
Almost half of the sample met the established criteria for clinical change, only 63 percent of this sample experienced positive clinical change. The other 37 percent deteriorated over the course of treatment. These differences were consistent across gender. History of trauma was the strongest predictor of clinically and statistically significant change in residential treatment. The number of types of trauma to which a youth was exposed prior to residential placement was negatively associated with treatment outcome. Exposure to community violence was also related to poor treatment outcome. Clinicians should consider alternative treatment programs for those clients who exhibit characteristics that coincide with failure to improve in a residential treatment setting. Extended exposure to complex trauma suggests the need for alternative treatment programs. More detailed study of the relationship between severity of trauma history and a youth's ability to benefit from restrictive care is needed to determine which traumatized youth could benefit from residential treatment and which youth might best be served in community-based settings. The final study sample consisted of 109 children between the ages of 5 and 12 years old at the time of their admission to the program; 78.9 percent of the sample was male. Researchers developed a peer-validated 60-item predictive index in order to obtain psychosocial, psychiatric, interpersonal, family system, and demographic data. Data on the trauma history of each subject was collected from medical and clinical records. Clinical outcome was evaluated using the Devereux Scale of Mental Disorders (DSMD), a 110-item behavioral rating scale that measures psychopathology in youth based on the frequency of specific behaviors over the past 4 weeks. 1 figure, 1 table, and 20 references