Admitting Whole Families: An Alternative to Residential Care

Abstract

This paper is an examination of the effectiveness of a programme (described in detail elsewhere) designed to admit whole families for short-term intensive assessment and treatment. The goals of this programme are to eliminate residential care for symptomatic children who are admitted with their families to this service, to decrease the length of stay of the symptomatic child in residential treatment, if this is required following admission of the whole family to this unit, and to provide these services at costs comparable to or less than that currently being spent with conventional residential treatment. Results stemming from a number of pre- and post-treatment measures indicate that one half of the children initially assessed and recommended for inpatient treatment had successfully avoided inpatient treatment for six months following admission of their family to this unit. For children recommended for residential care after admission of their families to the family unit, a reduction of approximately 35% of total time in residence occurred (when compared with a comparison group). A cost saving of over +12,000 per case was realized as a result of admission of the whole family when compared with residential treatment.

Intensive family therapy: a way to change family functioning in multi‐problem families

“…Since this is an expensive treatment method it must be thoroughly evaluated. Some evaluation studies of different size, design and ambition have been made (Johnson and Savage, 1967;Abroms et al, 1971;Ro-Trock et al, 1977;Ringstad and Spurkland, 1978;Churven and Durrant, 1983;Dydyk et al, 1989;Larsen and Eldrup, 1989) showing the model's effectiveness. In Sweden there are a number of minor evaluation studies (Braaf and Hedlund, 1981;Sundelin et al, 1991;Hansson et al, 1992;Lindberg, 1993;Nerström-Bjerre, 1993;Johansson, 1995;Sköld and Österholm, 1995;Abrahamsson, 1996).…”

Family Involvement in the Residential Treatment of Children: A Systemic Perspective

“…To deal with the problem of identifying a child as the problem family member, some programmes advocate the admission of the entire family for therapy (e.g. Dydyk, French, Gertsman and Morrison, 1989). Such an approach clearly identifies the family as the target for intervention, minimising the blame associated with individual family members.…”

Economic Evaluation of Family-Based Therapies for Children and Adolescents: what do we know?

“…It was also found to be cost effective for most of the studies on mental health, psychosomatic, and relational disorders. We note that family therapy was found both cheaper and more effective than treatment as usual for patients with asthma (34) and patient with psychosomatic disorders (22), and it was found cheaper and with equal effectiveness than the comparator for adolescents with symptomatic behaviours (35) and relational disorders (33). An exception to the cost effectiveness of family-based therapy for mental health disorders is the study on clinically anxious children (19), which showed that family CBT compared with individual CBT was of equal cost and effectiveness, but concluded that individual CBT had the highest probability of being cost effective in both cost per anxiety-free child and cost per QALY when modelling the CEA.…”

“…Finally, the study on asthma used the reduction in asthma symptoms as a health outcome (34). Some studies used health care use and the reduction in hospital length of stay as measures of effectiveness (22,35).…”