Use of a routine, self-report outcome measure (HoNOSCA–SR) in two adolescent mental health services

Gowers, Simon; Levine, Warren; Bailey-Rogers, Sarah J.; Shore, Adam; Burhouse, Emma

doi:10.1192/bjp.180.3.266

Cited by 70 publications

(73 citation statements)

References 11 publications

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“…HoNOSCA-SR (Gowers, Levine, Bailey-Rogers, Shore, & Burhouse, 2002) This is an adolescent self-rated version of HoNOSCA whose psychometric properties have recently been described.…”

Section: Motivational Questionnairementioning

confidence: 99%

The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa

Gowers

Smyth

2004

Euro Eating Disorders Rev

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This study was a pilot for a larger study to evaluate a time-limited outpatient programme for adolescent anorexia nervosa, to explore the ability of an assessment interview to change self-reported motivation and ascertain the extent to which this predicted engagement with treatment and early behavioural change. Fortytwo adolescents with anorexia nervosa rated their motivation for change before and after attending a new-style assessment interview. Initial (6 week) effectiveness of the programme was evaluated by measuring engagement with treatment, weight change, clinician (HoNOSCA) and self-rated (EDI, MFQ, HoNOSCA-SR) outcome measures, overall and in relation to motivational status. The assessment interview significantly improved motivation. Motivational category after interview was unrelated to physical status, cognition or general functioning but predicted engagement with treatment. Whilst for the whole sample, treatment produced physical, cognitive and general improvements at 6 weeks, motivational status was a powerful predictor of weight gain. A clientcentred assessment interview engaged 80% in an outpatient programme based on CBT. Motivational enhancement may improve engagement and specifically result in behavioural change and early weight gain.

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“…HoNOSCA-SR (Gowers, Levine, Bailey-Rogers, Shore, & Burhouse, 2002) This is an adolescent self-rated version of HoNOSCA whose psychometric properties have recently been described.…”

Section: Motivational Questionnairementioning

confidence: 99%

The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa

Gowers

Smyth

2004

Euro Eating Disorders Rev

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“…Intake HoNOSCA scores for in-patient samples are typically higher than those for outpatient samples [3,9]. Adolescents tend to score higher than children on suicide ideation, selfinjury, substance abuse and depressive symptoms [3,8].…”

mentioning

confidence: 97%

The Health of the Nation Outcome Scales for Children and Adolescents in an Adolescent In-Patient Sample

Harnett

Loxton

Sadler

et al. 2005

Aust N Z J Psychiatry

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“…For example, although HoNOSCA scores improve, the size of the reduction is less than that found for child and adolescent inpatients (Garralda et al, 2010;Gowers et al, 2002). This may occur because the admission HoNOSCA scores are slightly lower than in the inpatient unit, so less change might be expected, but more importantly, the day-patients were deliberately discharged when it was felt they could manage at home or in community settings although it was known they were still quite impaired.…”

Section: Discussionmentioning

confidence: 80%

“…This rates 13 clinical features on a five-point severity scale, and a higher score indicates more symptoms and problems, with a maximum score of 52 (Gowers et al, 1999). The instrument has satisfactory reliability and validity (Gowers et al, 2002;Harnett et al, 2005). It has been widely used as an outcome measure in CAMHS, including for the evaluation of child and adolescent day programmes (Kennair et al, 2011) and inpatient settings (Garralda et al, 2010).…”

Section: Methodsmentioning

confidence: 99%

The benefits of an adolescent psychiatric day service: the Harrow experience – a pilot study

Tovey

Perez‐Olaizola²,

Annecke³

et al. 2012

Journal of Children's Services

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PurposeThe purpose of this study is to describe the characteristics of severely psychiatrically impaired adolescents requiring day hospital management and the effectiveness of the service using standardised outcome measures.Design/methodology/approachThe data was collected on adolescents aged 13‐17 years in two London boroughs, attending the day service over a period of one year. Outcome measures were HoNOSCA, CGAS, SDQ and qualitative data from feedback forms from adolescents and parents.FindingsThe adolescents (n=22) had varied disorders, but mainly depression, (n=9) and psychosis (n=4). HoNOSCA score on admission was mean 18.14 (SD 3.78) but by discharge it had reduced to mean 15.39 (SD 7.31) (p=0.07), and CGAS reduced from initial mean score of 43.83 (SD 9.90) to 53.17 (SD 12.04) (p=0.003). Attendance for 19 (86 per cent) adolescents was for less than six months. Following discharge 14 (64 per cent) returned to education or employment. Adolescents and their carers reported high levels of satisfaction. The findings indicate substantial improvement and satisfaction with the service. The size of the improvement in outcome scores and the consistency across the HoNOSCA and CGAS associated with high service satisfaction also suggest that the data is reliable.Research limitations/implicationsThe small size of the sample and loss of data made it difficult to extrapolate from the results to other groups of impaired adolescents. There was no control group in the study and therefore it was not possible to demonstrate whether the improvement was due to spontaneous changes over time, Tier 3 CAMHS input or the attendance at the day service. It is difficult to demonstrate what proportion of adolescents who were admitted to the day service would have required a Tier 4 in patient admission had the service not been available. A larger study using a more robust design involving randomisation to the day‐service or in‐patient service would provide important comparative data regarding the service benefits.Originality/valueCurrently there is little provision for severely psychiatrically impaired adolescents who require a day treatment programme. Day patient programmes appear to offer a useful and accessible treatment method. The service is much cheaper than an in‐patient service, and may also reduce the demands for or duration of inpatient admission. Unfortunately the service did not obtain continuation funding in view of NHS funding cuts, rather than dissatisfaction by local commissioners, and so needed to close. The data presented here can hopefully be used to support the case for child and adolescent psychiatric day programmes.

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Use of a routine, self-report outcome measure (HoNOSCA–SR) in two adolescent mental health services

Abstract: Routine outcome measurement can include adolescent self-rating with modest additional resources. The discrepancy between staff and adolescent views requires further evaluation.

Cited by 70 publications

References 11 publications

The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa

The impact of a motivational assessment interview on initial response to treatment in adolescent anorexia nervosa

The Health of the Nation Outcome Scales for Children and Adolescents in an Adolescent In-Patient Sample

The benefits of an adolescent psychiatric day service: the Harrow experience – a pilot study

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