Date of Award

1996

Document Type

Dissertation

Degree Name

Doctor of Philosophy

School

School of Education

Program

Counseling Psychology, Ph.D.

First Advisor

Frederick A. Kosinski, Jr.

Second Advisor

Wilfred G. A. Futcher

Third Advisor

Lenore S. Brantley

Abstract

Problem. With the advent of managed care has come the increasing necessity to provide effective and efficient services to children and families experiencing severe emotional disturbances. The use of cost-effective and therapeutically effective services is at the crux of an effective service delivery system. Few studies have considered the usefulness and comparative effectiveness of face-to-face versus telephone interventions in therapeutic situations. This study considered the clinical value of face-to-face community mental health worker involvement during and after psychiatric inpatient hospitalizations of children and adolescents ages 11-17. The study also considered the comparative value of this follow-up when using master's-trained, mental health therapists versus bachelor's-trained mental health specialists.

Method. The 52 subjects in this study were 11-17-year-old children and adolescents who were screened and subsequently admitted to psychiatric inpatient units. They were assigned to either the face-to-face or telephone conditions and followed up by either mental health therapists or mental health specialists. Parents were administered the Personality Inventory for Children (PIC) in order to obtain scores on the depression subscale. Children and adolescents were administered the Children's Depression Inventory (CDI). Dependent variables included level of depression as determined by post-test scores and length of hospital stay.

Results. The results of this study indicated that there was no significant difference in the use of face-to-face versus telephone interventions or in the use of mental health therapists versus mental health specialists using the clinical outcome indicators identified in this study. An unanticipated finding of this study involved the relative stability of parents' scores between pre-test and post-test, indicating very little difference in parent assessment of improvement in depression compared with child and adolescent self-reported improvement between pre-test and post-test.

Conclusions. There may be very little difference in major clinical outcomes using telephone contacts versus face-to-face contacts in some clinical situations. The use of more extensively trained and more highly educated staff may not be necessary in certain clinical situations. Further study should occur that investigates the disparity between parent assessment of their children's emotional and mental states versus child and adolescent self-report.

Subject Area

Child psychiatry, Child mental health services, Parent and child

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