319P
The Impact of a Health and Wellness Group Intervention on Successful Discharges for Adolescents in Residential Treatment Facilities: A Matched Propensity Score Analysis
Description of Problem: Youth receiving services in residential treatment settings (RTFs) have complex and interrelated challenges requiring innovative and integrated treatment approaches to improve outcomes and increase success rates. Youth in RTFs are typically diagnosed with a serious emotional disturbance (SEDs), have high rates of trauma, extreme psychosocial and environmental stressors, elevated risk behaviors, and increased rates of comorbid physical health disorders - all of which necessitate an integrated and multidimensional treatment approach (Abramovitz & Bloom, 2003; Leichtman, 2001) .
Purpose/Specific Aims: The purpose of the study was to test the effectiveness of a health and wellness intervention on success at discharge. Does the health and wellness intervention improve the outcome success at discharge in the intervention RTF relative to the treatment as usual (TAU) RTF? It was hypothesized that the intervention would significantly improve success at discharge in the intervention group relative to the TAU RTF.
Methods
Design: Quasi-experimental design with a TAU comparison group.
Sample: The matched sample consisted of 62 youth, both male and female between the ages of 11 and 18.
Intervention: The intervention was a health and wellness intervention that consisted of psychoeducation, family engagement, behavioral skills training, a meal and snack protocol, and a fitness and activity protocol.
Data Collection and Measures: Data was collected by the RTF staff in addition to the integration/intake team. Data was extracted from closed records for youth who were admitted and discharged from one of the two RTFs within a three year time frame. The primary measure used to assess success at discharge was developed by the organization to track key outcomes at discharge.
Data Analyses: Sample data was analyzed using descriptive statistics. A propensity score-matched analysis was used to match youth across the two RTFs. Logistic regression was used to examine the primary research question.
Results: Results showed that youth in the intervention RTF were significantly more likely to be successfully discharged relative to the TAU RTF youth (p = .001). Approximately 96% of youth in the intervention RTF were discharged successfully as compared to 77.8% in the TAU RTF.
Conclusions and Implications: The health and wellness intervention produced significantly more successful discharges in the intervention group relative to the TAU group which indicates that the intervention increased youth and family skills, decreased the need for high intensity services, improved rates of goal accomplishment, and reduced risk behaviors. The intervention had an impact on areas of improvement required for successful discharges which is considered a proxy for functioning and well-being post-discharge. By addressing all domains of healthy development and expanding traditional services to include an integrated health and wellness intervention, overall change was seen in domains beyond just mental health which ultimately increased treatment success at discharge.
Abramovitz, R., & Bloom, S.L. (2003). Creating sanctuary in residential treatment for youth: From the “well-ordered asylum” to the “living-learning environment”. Psychiatric Quarterly, 74(2), p. 119-135.
Leichtman, M. (2006). Residential treatment of children and adolescents: Past, present, and future. American Journal of Orthopsychiatry, 76(3), p. 285-294. doi: 10.1037/0002-9432.76.3.285.