The authors report outcomes for 4,777 youth served by the public mental health system in Michigan who had problems in school, at home, in interpersonal relationships, or in modulating their mood. Cluster analysis identified five subgroups: Pervasive Problems with Mood Disturbance (i.e., severe or moderate impairment in school, at home, in behavior toward others, and in mood); School Problems with Mood Disturbance; Home Problems with Mood Disturbance; School and Home Problems; and Mild Behavior/Mood Problems. Outcome was defined as the proportion of youth whose functioning changed from severe or moderate impairment to mild impairment or no impairment on each of the relevant subscales of the Child and Adolescent Functional Assessment Scale (CAFAS).The results indicated that youth with pervasive impairment across domains (i.e.,the Pervasive Problems with Mood cluster) had the poorest outcomes.The authors present recommendations for research protocols that match evidence-based treatments to type and extent of impairment, as reflected by cluster membership, which in turn corresponded to differential profiles of scores on the CAFAS.
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