In-Home versus Clinic-Based Services for the Developmentally Disabled Child

Abstract

This paper analyzes two different approaches to service delivery, in-home and clinic-based, in order to assist planners and clinicians in utilizing the merits of both systems most effectively. The two systems are compared and contrasted along the following variables: team process, identified client, pace of treatment, and degree of coverage. Using these variables as a guideline, this paper proposes that the degree to which the family's priorities are similar or dissimilar to the priorities of the organization determines the degree of effectiveness of home-based or clinic-based services. This proposal is discussed and case histories illustrating this premise are presented.

A model for home-based psychology from the veterans health administration.

“…Confidentiality issues can be particularly difficult to navigate in a patient's home where the psychologist is a guest. As already noted, the balance of power normally experienced in the outpatient office setting is equalized in the home (Mueller & Leviton, 1986) so the psychologist has less control over the session and may feel less comfortable asking family members to leave (Mueller & Leviton, 1986; Synder & McCollum, 1999). Some family who would comply with a request for privacy in the office may require more explanation and assurance when this same request is given in the home.…”

Family-Focused Treatment: A Speech-Language Pathologist's Role in a Home-Based Parent Training Program

“…The pripeting priorities that need to be resolved mary clinician and the family together debefore the family is ready to deal with the termine appropriate intervention strategies needs of the child and the demands of a to address the special needs of other family treatment program. 3 In these instances, the members. social worker is often the primary clinician,…”

“…match the child's therapeutic needs, the primary clinician may over time be able to stabilize this problem-solving mode and, as CHILD AND FAMILY SUPPORT the family's stated priorities are addressed, PROGRAM gradually introduce goals related to the child's needs. 3…”