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Schedule:
Sunday, January 15, 2017
Bissonet (New Orleans Marriott)
* noted as presenting author
Background: While extant clinical and research literature posits the utility of obtaining information about the psychosocial functioning of youth in mental health treatment from multiple sources (often referred to as triangulation), few studies provide sufficient sample size to fully tease apart the mechanisms by which informant discrepancies occur. In-depth examination of such discrepancies (as well as areas of agreement) can provide insight regarding how clinicians can use triangulation to improve psychosocial assessment, mental health treatment, and client outcomes. Therefore, the objective of this presentation will be to examine parent and adolescent assessment and agreement regarding psychosocial functioning in a community-based clinical population.
Methods: Data were collected from a sample of youth ages 13 to 17 attending five outpatient mental health treatment centers in the Los Angeles area, as well as from one of their parents (or caregivers). The client base attending the centers is representative of the population typically served by similar community mental health centers in the Southern California region. The analytic sample is comprised of 330 parent-child dyads that participated in treatment between 2011 and 2015 and who completed outcome measures at both intake and discharge (approximately 6 months apart). Outcome measures included in this study are the Youth Outcome Questionnaire (YOQ), completed by parent, and the Youth Outcome Questionnaire – Self-Report (YOQ-SR), completed by the client. These measures (collectively referred to as “OQ series”) provide information about the client’s presenting problems and level of psychosocial functioning. Both measures are comprised of six subscales and a Total score, and have been found to be valid, reliable, and sensitive to change over short periods of time among this population.
Results: Youth characteristics: 59% female; 70% Latino; 18% African American; mean age=14.6 years. OQ series scores reflecting youth psychosocial functioning significantly improved between intake and discharge, regardless of reporter and across all subscales (all T-values significant at p<0.01). Total scores for both YOQ and YOQ-SR moved from the “clinical” range at intake (YOQ: 54.8; YOQ-SR: 54.6) to “normal” range at discharge (YOQ: 39.1; YOQ-SR: 37.2). However, rates of improvement between intake and discharge varied by reporter: 69% improved according to parent report, 77% according to client self-report. Closer examination of discrepancies between parent- and client-reported scores indicated that the larger improvements found among self-report scores were concentrated among certain groups of clients (i.e., females), and in certain domains (i.e., Intrapersonal Distress).
Conclusions: While adolescent psychosocial functioning tends to improve over the course of mental health treatment, parents and clients may have quite divergent perspectives regarding the amount of improvement achieved and in what areas the client has demonstrated growth. This study contributes to the theoretical framework described by the Attribution Bias Context Model (De Los Reyes & Kazdin, 2005), which argues that further exploration of informant discrepancies – including how different respondents attribute causes of youth’s behavior and have divergent goals about the clinical assessment process -- is needed for the field to fully understand the complex systems contributing to adolescent mental health and treatment.
Methods: Data were collected from a sample of youth ages 13 to 17 attending five outpatient mental health treatment centers in the Los Angeles area, as well as from one of their parents (or caregivers). The client base attending the centers is representative of the population typically served by similar community mental health centers in the Southern California region. The analytic sample is comprised of 330 parent-child dyads that participated in treatment between 2011 and 2015 and who completed outcome measures at both intake and discharge (approximately 6 months apart). Outcome measures included in this study are the Youth Outcome Questionnaire (YOQ), completed by parent, and the Youth Outcome Questionnaire – Self-Report (YOQ-SR), completed by the client. These measures (collectively referred to as “OQ series”) provide information about the client’s presenting problems and level of psychosocial functioning. Both measures are comprised of six subscales and a Total score, and have been found to be valid, reliable, and sensitive to change over short periods of time among this population.
Results: Youth characteristics: 59% female; 70% Latino; 18% African American; mean age=14.6 years. OQ series scores reflecting youth psychosocial functioning significantly improved between intake and discharge, regardless of reporter and across all subscales (all T-values significant at p<0.01). Total scores for both YOQ and YOQ-SR moved from the “clinical” range at intake (YOQ: 54.8; YOQ-SR: 54.6) to “normal” range at discharge (YOQ: 39.1; YOQ-SR: 37.2). However, rates of improvement between intake and discharge varied by reporter: 69% improved according to parent report, 77% according to client self-report. Closer examination of discrepancies between parent- and client-reported scores indicated that the larger improvements found among self-report scores were concentrated among certain groups of clients (i.e., females), and in certain domains (i.e., Intrapersonal Distress).
Conclusions: While adolescent psychosocial functioning tends to improve over the course of mental health treatment, parents and clients may have quite divergent perspectives regarding the amount of improvement achieved and in what areas the client has demonstrated growth. This study contributes to the theoretical framework described by the Attribution Bias Context Model (De Los Reyes & Kazdin, 2005), which argues that further exploration of informant discrepancies – including how different respondents attribute causes of youth’s behavior and have divergent goals about the clinical assessment process -- is needed for the field to fully understand the complex systems contributing to adolescent mental health and treatment.