On the Meaning and Measurement of Engagement in Youth Residential Treatment Centers

Cunningham, Wm. Scott; Duffee, David E.; Huang, Yufan; Steinke, Camela M.; Naccarato, Toni

doi:10.1177/1049731508314505

Cited by 45 publications

(53 citation statements)

References 33 publications

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“…Young people in the study by Cunningham et al 649 had a somewhat different profile in that the majority were in residential care ('congregate foster care') as the result of being in need of supervision (53%), and it is not entirely clear whether or not they had a history of maltreatment. A further 38% were adjudicated delinquents and 9% had been referred for reasons including abuse, neglect and special educational needs.…”

Section: Participantsmentioning

confidence: 94%

“…Cunningham et al 649 described the development of a measure of youth engagement that was suitable for use with young people in RTCs. In collaboration with staff from two RTCs, the research team established a programme logic model, which they used to develop a multidimensional measure of engagement, adapting items from existing measures of readiness to change and the therapeutic alliance.…”

Section: Methodsmentioning

confidence: 99%

“…A further 38% were adjudicated delinquents and 9% had been referred for reasons including abuse, neglect and special educational needs. It is possible that -with additional information -this study 649 would fail to meet our inclusion criteria in respect of participants.…”

Section: Participantsmentioning

confidence: 99%

“…A total of 154 adolescent girls participated in the Leenarts et al 672 study and 130 young people were interviewed on four occasions by the researchers in the study by Cunningham et al 649 Shennum and Carlo 650 recruited a sample of 80 young people and Gallagher and Green 666 achieved a sample of just 16. Thirty-nine girls participated in focus groups in the study by West et al…”

Section: Sample Sizesmentioning

confidence: 99%

“…The therapeutic residential settings ranged from a compulsory treatment facility for severely traumatised girls 651,672 through residential treatment 649,650 to a small domestic-style setting described as a Therapeutic Children's Home, 666 where children lived in 'families' of three or four children with two adult staff acting in loco parentis. In this setting, the therapeutic model comprised three components: therapeutic parenting (to address attachment issues and a secure base), formal therapy sessions (based on play and expressive arts) and life story work.…”

Section: Interventionsmentioning

confidence: 99%

See 4 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Participantsmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Sample Sizesmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

See 3 more Smart Citations

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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Treatment engagement as a predictor of premature treatment termination and treatment outcome in a correctional outpatient sample

Drieschner¹,

Verschuur²

2010

Criminal Behav Ment Health

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A systematic review of measures of therapeutic engagement in psychosocial and psychological treatment

Tetley¹,

Jinks²,

Huband³

et al. 2011

J Clin Psychol

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This article reports a systematic review of engagement measures for psychosocial therapy. MEDLINE, EMBASE, and PsycINFO databases were searched to identify English-language studies (published 1980 to February 2010) that reported on an instrument/rating scale to measure engagement in psychosocial treatment for mental health difficulties. Forty-seven studies were identified, reporting information on 40 measures of treatment engagement. Although our findings suggest that therapeutic engagement appears to be considered an important construct to assess, they also reveal that there is little consensus in the definition of engagement employed. Few measures are generalizable across treatment settings and clinical populations, and limited information is reported on the indices of reliability and validity. It is concluded that further work is required to develop adequate measures of therapeutic engagement.

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On the Meaning and Measurement of Engagement in Youth Residential Treatment Centers

Cited by 45 publications

References 33 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Treatment engagement as a predictor of premature treatment termination and treatment outcome in a correctional outpatient sample

A systematic review of measures of therapeutic engagement in psychosocial and psychological treatment

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