Do inpatients on adolescent units recover? A study of outcome and acceptability of treatment

Jaffa, Tony; Stott, Carol

doi:10.1007/s007870050104

Cited by 21 publications

(30 citation statements)

References 12 publications

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“…Balkin and Roland (2007) advocated for utilizing a goal attainment model for adolescents in psychiatric hospitalization, which was effective regardless of differential diagnostic labels. This implication was contrary to the suggestion by Cornsweet (1990) and Jaffa and Stott (1999) that adolescent clients with emotional disorders tend to have more positive outcomes than clients diagnosed with disruptive behavior disorders. The manner in which outcomes were measured, however, in Balkin and Roland's research was quite different.…”

Section: Introductioncontrasting

confidence: 93%

“…Balkin and Roland (2005) further identified that the goal attainment model was effective in reducing psychiatric symptoms, regardless of client diagnosis. This finding was validated further in this study; Jaffa and Stott's (1999) assertion that clients with emotional disorders have a more positive prognosis than clients with disruptive behavior disorders was addressed as well.…”

Section: Discussionsupporting

confidence: 68%

“…Jaffa and Stott (1999) suggested that clients with emotional disorders might have more positive outcomes than clients with disruptive behavior disorders. While the suggestion of diagnostic differences was not exemplified in this study, clients who indicated elevated emotional symptoms tended to have higher levels of therapeutic goal attainment.…”

Section: Discussionmentioning

confidence: 99%

“…Within the context of psychiatric hospitalization, clients with diagnoses of anxiety, depression, and/or adjustment disorder tended to have higher rates of successful outcomes than clients diagnosed with disruptive behavior disorders (Cornsweet, 1990;Jaffa & Stott, 1999). Jaffa and Stott (1999) suggested that adolescents diagnosed with emotional disorders have a more positive prognosis than adolescents diagnosed with disruptive behavior disorders, but their study was inconclusive due to limited sample size for diagnostic groups.…”

Section: Introductionmentioning

confidence: 99%

“…Jaffa and Stott (1999) suggested that adolescents diagnosed with emotional disorders have a more positive prognosis than adolescents diagnosed with disruptive behavior disorders, but their study was inconclusive due to limited sample size for diagnostic groups. Ivarsson et al (1998) studied 191 adolescents previously admitted to psychiatric hospitals in Sweden.…”

Section: Introductionmentioning

confidence: 99%

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Assessing the relationship between therapeutic goal attainment and psychosocial characteristics for adolescents in crisis residence

Balkin

Leicht

Sartor

et al. 2011

Journal of Mental Health

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Section: Introductioncontrasting

confidence: 93%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assessing the relationship between therapeutic goal attainment and psychosocial characteristics for adolescents in crisis residence

Balkin

Leicht

Sartor

et al. 2011

Journal of Mental Health

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Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

O’Kearney

Anstey

Sanden

et al. 2006

Cochrane Database of Systematic Reviews

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Analysis 1.2. Comparison 1 BT/CBT versus waitlist or placebo, Outcome 2 Number with OCD at post treatment.. Analysis 1.3. Comparison 1 BT/CBT versus waitlist or placebo, Outcome 3 NIMH-GOCS at post treatment.. . Analysis 1.4. Comparison 1 BT/CBT versus waitlist or placebo, Outcome 4 Clinical Global Impressions-Improvement. Analysis 1.5. Comparison 1 BT/CBT versus waitlist or placebo, Outcome 5 Change in CY-BOCS prior to post.. . Analysis 2.1. Comparison 2 BT/CBT versus medication, Outcome 1 CY-BOCS score at post treatment.. .. . Analysis 2.2. Comparison 2 BT/CBT versus medication, Outcome 2 Number with OCD at post treatment.. .. Analysis 2.3. Comparison 2 BT/CBT versus medication, Outcome 3 NIMH-GOCS at post treatment.. .. . .

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Cochrane review: Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

O'Kearney

Anstey²,

Sanden³

2007

Evid.‐Based Child Health

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BackgroundWhile behavioural or cognitive‐behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with obsessive‐compulsive disorder (OCD), the application of BT/CBT to paediatric OCD may not be straightforward.ObjectivesThis review examines the overall efficacy of BT/CBT for paediatric OCD, its relative efficacy against psychopharmacology and whether there are benefits in using BT/CBT combined with medication.Search strategyWe searched CCDANCTR‐Studies and CCDANCTR‐References (searched on 5/8/2005), MEDLINE, EMBASE, PsycINFO, the reference lists of all selected studies and handsearched journals specifically related to behavioural treatment of OCD.Selection criteriaIncluded studies were randomised controlled trials or quasi‐randomised trials with participants who were 18 years of age or younger and had a diagnosis of OCD, established by clinical assessment or standardised diagnostic interview. Reviewed studies included the standard behavioural or cognitive‐behavioural techniques, either alone or in combination, compared with wait‐list or pill placebo.Data collection and analysisThe quality of selected studies was assessed by two independent reviewers. The primary outcomes comprised of endpoint scores on the gold standard clinical outcome measure of OCD symptoms, distress and interference (CY‐BOCS) and endpoint OCD status.Main resultsFour studies with 222 participants were considered eligible for inclusion and for data extraction. Two studies showed significantly better post‐treatment functioning and reduced risk of continuing with OCD at post‐treatment for the BT/CBT group compared to placebo or wait‐list comparisons. We suggested that the POTS 2004 result, equal to a difference of about eight points on the CY‐BOCS, represented the best available estimate for the efficacy of BT/CBT relative to no treatment. (WMD ‐7.50; 95% CI ‐11.55, ‐3.45). Pooled evidence from two trials indicated that the efficacy of BT/CBT and medication did not differ significantly (WMD ‐3.87; 95% CI ‐8.15, 0.41). There was evidence of the benefit of combined BT/CBT and medication compared to medication alone (WMD ‐4.55; 95% CI ‐7.40, ‐1.70), but not relative to BT/CBT alone (WMD ‐2.80; 95% CI ‐7.55, 1.95). The rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families.Authors' conclusionsAlthough only based on a small number of studies, behavioural or cognitive‐behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.Plain language summaryPlain language summaryBehavioural and cognitive‐behavioural therapy for obsessive‐compulsive disorder (OCD) in children and adolescentsThe onset of obsessive‐compulsive disorder often occurs in childhood and adolescence. It can be an extremely debilitating disorder, resulting in high levels of distress, impairment and disruption of psychosocial development. It also has a considerable impact on other family members. While there is evidence that medication can reduce symptoms, behavioural and cognitive‐behavioural therapy (BT/CBT) are often proposed as acceptable alternative treatments. These therapies have various components, but commonly include assisting the child to better tolerate the anxiety provoking situations and thoughts, without the use of compulsive behaviour to manage their anxiety. Other components include psycho‐education about anxiety and OCD, cognitive training involving learning to identify and challenge unhelpful ways of thinking, and parental involvement.This review identified four RCTs, involving 222 participants, evaluating the benefits of behavioural and cognitive‐behavioural therapy. The results from two individual studies show that, compared to a wait‐list or pill placebo, BT/CBT is an effective treatment for reducing OCD symptoms and lowering the risk of having OCD after treatment. Based on two studies that directly compared BT/CBT with anti‐OCD medication, there was no evidence to suggest that either BT/CBT or anti‐OCD medication was superior to the other. When combined with medication, BT/CBT produces better outcomes than medication alone, but combining medication and BT/CBT does not result in better outcomes than BT/CBT alone.Although based on a small number of studies, these findings provide some support for the potential value of BT/CBT in the treatment of children and adolescents with OCD. Sufferers and their families may wish to enquire about the appropriateness of BT/CBT, and to request information about the availability of appropriately skilled clinicians.

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Do inpatients on adolescent units recover? A study of outcome and acceptability of treatment

Abstract: It is possible to investigate outcome in an adolescent unit. The results are encouraging and indicate that this form of treatment can be effective and acceptable.

Cited by 21 publications

References 12 publications

Assessing the relationship between therapeutic goal attainment and psychosocial characteristics for adolescents in crisis residence

Assessing the relationship between therapeutic goal attainment and psychosocial characteristics for adolescents in crisis residence

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

Cochrane review: Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents

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