Adolescent day programs : their nature, impact and mechanisms of change

The thesis reports on three studies which investigated the following phenomena. Adolescent day programs (ADPs) are the preferred treatment option for a substantial number of Australian adolescents whp suffer from mental health disorders, but little empirical research has been conducted on what sonstitutes an ADP, whether such programs have efficacy, and if they do, what factors contribute to their efficacy. The professional portfolio reviews the existing literature on parent abuse before considering the relevance of this information for clinical practice by examining four cases of parent abuse that were treated in a Child and Adolescent Mental Health Service

Curative factors in adolescent day programs: participant, therapist, and parent perspectives

Adolescent day programs (ADPs) have treatment outcomes as good as, or better than,regular outpatient treatment for adolescents who present with emotional, behavioral, social,and psychiatric disorders. However, they may be more costly, and the mechanisms of changewithin them are unknown. Identification of the most important curative factors couldenable the streamlining of these programs. This descriptive study examined the perceptionsof curative factors in ADP treatment as rated by 38 participants, 51 of their parents, and14 clinicians. Findings were variable across informant groups. Adolescent respondentsreported Universality, Acceptance, Learning from Interpersonal Action, Decision Making,Altruism, Guidance, and Instillation of Hope to be equally the most helpful curative factorsin the program. Clinicians ranked Acceptance to be the most important factor, followed byDecision Making, Self-Understanding, Vicarious Learning, and Universality. Parentsranked Acceptance, Universality, Guidance, and Instillation of Hope as being most helpful.The findings provide directions for the enhancement of ADPs

Evaluating the outcomes of adolescent day programs in an Australian child and adolescent mental health service

Adolescent day programs (ADPs) are an increasingly used approach to treating adolescents with mental health issues. However, there is a dearth of studies empirically examining the outcomes of adolescent day programs. This study retrospectively examined the mental health functioning of 84 adolescents, pre- and post-treatment, who in addition to their ongoing outpatient treatment had participated in an ADP during a five-year period. Their functioning was compared to matched adolescents who participated only in outpatient treatment during the same time period. Statistical and clinical examinations revealed the reported outcomes following ADP treatment were at least comparable, and sometimes significantly better, when compared to the reported outcomes following outpatient treatment excluding ADP involvement. This study, while having some methodological shortcomings, provides some evidence for the efficacy of ADPs.<br /

Parent abuse: a review

A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily focused on prevalence rates and the characteristics of perpetrators and victims. While various factors such as gender, age, emotional attachment to parents, race/ethnicity, socioeconomic status, family stress and parenting style and structure have been associated with parent abuse, findings are equivocal. Etiological models are general and untested, and treatment approaches lack empirical support. It is concluded that more rigorous and extensive research is required in order to provide a deeper understanding of this complex issue, and to inform treatment approaches.<br /