In this article, we describe the outcomes associated with a 3-year research demonstration project. It is the second of a two-part article concerned with this research conducted in the Bronx, New York, to examine the efficacy of three models of intensive in-home services—Home-Based Crisis Intervention (HBCI), Enhanced Home-Based Crisis Intervention (HBCI+),and Crisis Case Management—as alternatives to hospitalization for children experiencing a psychiatric crisis. In Part I (Evans, Boothroyd, & Armstrong, 1997), we described the features of the three program models, the research design, data collection measures, and the presenting characteristics of the children and families. In Part 2, we describe the success of maintaining children at home (82%) and the increases in family adaptability, children's self-concept, and parental self-efficacy both at discharge and at 6 months postdischarge. Enrollees in two of the models (HBCI and HBCI+) experienced a significant increase in family cohesion,although this was not maintained at 6 months postdischarge. While enrollees in the enhanced program showed significant increase in social support at discharge, all enrollees experienced this at 6 months postdischarge.
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References
1.
Achenbach, T.M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
3.
Barrera, M., Jr. (1993). Notes on the ISSB. Tempe: Arizona State University, Psychology Department.
4.
Barrera, M., Jr., & Ainlay, S.L. (1983). The structure of social support: A conceptual and empirical analysis. Journal of Community Psychology, 11, 133-143.
5.
Barrera, M., Jr., Sandler, I.N., & Ramsay, T.B. (1981). Preliminary development of a scale of social support: Studies on college students. American Journal of Community Psychology, 9, 435-447.
6.
Boothroyd, R.A., & Evans, M.E. (1996). Preliminary manual for the Parent Self-Efficacy Scale. Albany: New York State Office of Mental Health, Bureau of Evaluation and Services Research.
7.
Brink, P.J., & Wood, M.J. (1998). Advanced design in nursing research (2nd ed.). Thousand Oaks, CA: Sage.
8.
Bryk, A.S., & Raudenbush, S.W. (1992). Hierarchical linear models: Applications and data analysis methods. Beverly Hills, CA: Sage.
9.
Bureau of Evaluation and Services Research. ( 1989). Client description form. Albany: New York State Office of Mental Health, Bureau of Evaluation and Services Research.
10.
Bureau of Evaluation and Services Research. ( 1993). Emergency services assessment measure. Albany: New York State Office of Mental Health, Bureau of Evaluation and Services Research.
11.
Cohen, J. (1992). A power primer. Psychological Bulletin,112, 115-159.
12.
Evans, M.E. (1996). Family preservation services for children with emotional and behavioral disorders. In G. Pfeffer & D. K. Behera (Eds.), Contemporary society: Childhood and complex order (pp. 307-334). New Delhi, India: Manak Publications.
13.
Evans, M.E., Armstrong, M.I., Kuppinger, A.D., Huz, S., & McNulty, T.L. (1998). Preliminary outcomes of an experimental study comparing treatment foster care and family-centered intensive case management . In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation best practices (pp. 543-580). Austin: PRO-ED.
14.
Evans, M.E., Boothroyd, R.A., & Armstrong, M.I. (1997). The development and implementation of an experimental study of the effectiveness of in-home crisis services for children and their families. Journal of Emotional and Behavioral Disorders, 5, 93-105.
15.
Evans, M.E., Boothroyd, R.A., Greenbaum, P.E., Brown, E.C., & Armstrong, M.I. (2001). Outcomes associated with clinical profiles of children in psychiatric crisis enrolled in intensive in-home interventions. Mental Health Services Research, 3(1), 35-44.
16.
Fraser, M.W., Pecora, P.J., & Haapala, D.A. (1991). Families in crisis: The impact of intensive family preservation services. New York: Aldinede Gruyter.
17.
Freeman, B.J. (1985). Review of the Child Behavioral Checklist. In V. Mitchell, Jr. (Ed.), Ninth mental measurement yearbook (pp. 213-214). Lincoln: University of Nebraska Press.
18.
Gutterman, E., & Levine, K.G. (1992). Child and adolescent mental health assessment of imminent danger. New Brunswick, NJ: Rutgers University, Institute for Health, Health Care Policy, and Aging Research.
19.
Hall, K., Cascardi, M., & Kutash, K. (1996). CAFAS as an outcome measure in the alternatives to residential treatment study. In C. Liberton , K. Kutash, & R. Friedman (Eds.), The 8th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 355-360). Tampa: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health.
20.
Hampson, R.B., Hulgus, Y.F., & Beavers, W.R. (1991). Comparisons of self-report measures of Beaver's systems model and Olson's circumplex model. Journal of Family Psychology, 4, 326-340.
21.
Henggeler, S.W., Rowland, M.D., Randall, J., Ward, D.M., Pickrel, S.G., Cunningham, P.B., et al. (1999). Home-based Multisystemic Therapy as an alternative to the hospitalization of youths in psychiatric crisis: Clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1331-1339.
22.
Henggeler, S.W., Schoenwald, S.K., Borduin, C.M., Rowland, M.D., & Cunningham, P.B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York: Guilford Press.
23.
Hodges, K. (1990). Child and adolescent functional assessment scales . Ann Arbor: Eastern Michigan University .
24.
Huz, S., McNulty, T.L., & Evans, M.E. (1996). CAFAS as a measure of child and family functioning among children and families enrolled in intensive case management in New York state. In C. Liberton, K. Kutash, & R. Friedman (Eds.), The 8th annual research conference proceedings, a system of care for children's mental health: Expanding the research base (pp. 349-353). Tampa: University of South Florida, Florida Mental Health Institute , Research and Training Center for Children's Mental Health.
Keeping families together. Journal of Consulting and Clinical Psychology, 45, 667-673.
27.
Leginski, W.A., Croze, C., Driggers, J., Dump-man, S., Eertsen, D., Kamis-Gould, E., et al. (1989). Data standards for mental health decision support systems (Report No. ADM89-1589). Rockville, MD : National Institute of Mental Health.
28.
Magura, S., & Moses, B. S. (Eds.). (1986). Outcome measures for child welfare services. Washington, DC: Child Welfare League of America.
29.
Marin, G., Sabogal, F., Marin, B.V., Otero-Sabogal, R., & Perez-Stable, E.J. (1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9, 183-205.
30.
McConaughy, S.H., & Achenbach, T.M. (1988). Practical guide for the Child Behavior Checklist and related materials. Burlington : University of Vermont, Department of Psychiatry .
31.
Olson, D.H. (1991). Use of FACES II versus FACESIII. St. Paul: University of Minnesota, Family Inventories Project.
32.
Olson, D.H., Portner, J., & Bell, R. (1982). Family adaptability and cohesion evaluation scales . St. Paul: University of Minnesota, Family Social Science.
33.
Piers, E.V. (1984). Manual for the Piers-Harris Children's Self-Concept Scale. Nashville, TN: Counselor Recordings and Tests.
34.
Saville, D.J. (1990). Multiple comparison procedures: The practical solution. The American Statistician, 44, 174-180.
35.
Schoenwald, S.K., Ward, D.M., Henggeler, S.W., & Rowland, M.D. (2000). Multisystemic therapy versus hospitalization for crisis stabilization of youth: Placement outcomes 4 months postreferral. Mental Health Services Research, 2, 3-12.
36.
U.S. Department of Health and Human Services. ( 1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services.
