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To Order these reports contact: Susan Goetz at the Wilderness Research Center Cost: $10 per copy includes shipping and handling payable to Wilderness Research Center E-Mail: sgoetz@uidaho.edu or wrc@uidaho.edu Phone: 208.885.2267 |
Assessment of Treatment Outcomes in Outdoor Behavioral Healthcare By Keith C. Russell, Ph.D. Executive Summary This publication describes and reports results from a study of client outcomes in eight participating outdoor behavioral healthcare (OBH) programs. A pretest-posttest, research design was used to assess 858 out of 1035 clients (83%) who received OBH treatment from May 1, 2000 to December 1, 2000. Treatment outcomes were evaluated through client self-report and parent assessment of adolescent well-being at admission and discharge utilizing the Youth Outcome Questionnaire (Y-OQ) (Burlingame, Wells, & Lambert 1995). A subsequent report will present data from follow-up assessments on the same clients at three-, six-, and twelve-month periods. Clients were in OBH treatment for an average length of 38 days. The clients enrolling in the eight OBH programs during the period of this study were predominantly male (69%) and between the ages of 16-18 (75%). Clients entered treatment with a variety of disruptive behavioral, mood and substance disorders as their primary psychiatric diagnoses. Of the 481 clients for whom data were available on diagnoses, 48% also had a secondary diagnoses. Most prevalent were those diagnosed with behavioral disorders (38%), some form of substance abuse or dependence disorder (30%), and mood disorders (22%). Over half (57%) of the OBH clients had a history of outpatient treatment, 17 % had utilized inpatient services, and 13% had utilized both types of services prior to OBH treatment. Client self-report mean Y-OQ scores were 70.67 at admission and 47.55 at discharge, indicating an average score reduction of more than 20 points. Parent assessment Y-OQ mean scores were 101.19 at admission and 48.55 at discharge, indicating an average reduction of 52.64. Thus, parents rated the clients presenting symptoms as more severe than did the clients themselves, but they perceived symptoms at discharge that were very similar. Discharge scores for both client self report and parent assessment are close to the normal range of symptoms (46 or below) as established by Burlingame et al. (1995b) in their sample tests of normal populations. Client self-reported Y-OQ scores across all ages show similar reductions from admission to discharge, and with exception of 15-year olds, showed a trend of increasing score reductions with increasing age (16 to 18). Parent assessments across all age groups were higher at admission and showed similar reductions at discharge. Female clients report higher Y-OQ admission and discharge scores for both client self-report and parent assessments, and also showed a greater reduction in scores than males. However, discharge scores for females remained higher than for males (54.37 and 47.44 respectively). Results of this study
indicate that participation in OBH programs led to a statistically significant
reduction in the severity of behavioral and emotional symptoms, as perceived
by the clients, and even more so by their parents, as measured by the
Y-OQ questionnaire. A majority (55 %) of OBH clients participating in
this study had Y-OQ scores at discharge compatible with a normal range
of symptoms (46 or below) as established by Burlingame et al. (1995b)
in their sample tests of normal populations. When comparing the results
of this study to other outcome studies in the literature which used the
Y-OQ, OBH programs showed greater score reductions in shorter treatment
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