Treatment Readiness in Psychiatric Residential Care for Adolescents

Guy Diamond, Linda Ruan-Iu, Payne Winston-Lindeboom, Alannah Shelby Rivers, Guy Weissinger, Michael Roeske
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Abstract

There are many factors to consider when treating adolescents with psychiatric challenges, including whether they are willing and interested in participating in treatment. This study aimed to explore how treatment readiness impacts treatment experience for adolescents in psychiatric residential care who came into treatment with moderate to severe depression. All participants (N = 1,624; Mage = 15.58, SD = 1.46) were admitted to a large, multi-state psychiatric residential system between January 2020 and March 2022. Patients were 95.6% White, 99% non-Hispanic, and 64.7% identified as female. At intake, all patients were administered an assessment which includes the multi-dimensional Behavioral Health Screen (BHS) that assesses psychopathology and risk factors, a working alliance scale, depression, and well-being measures. Patients were also asked how they were admitted to the program, using a single item, multiple choice question as an informal treatment readiness measure, yielding three readiness groups: precontemplation, contemplation, or preparation. Regression analysis results indicated that patients’ readiness level was associated with different baseline characteristics (e.g., age, gender, psychopathology symptoms, risk factors) and week 3 outcomes (e.g., decreased symptoms, well-being, alliance, satisfaction). The clinical implications, as well as limitations and future directions, will be discussed.

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青少年精神病寄宿护理中的治疗准备。
在治疗患有精神疾病的青少年时,需要考虑很多因素,包括他们是否愿意并有兴趣参与治疗。本研究旨在探讨治疗准备程度如何影响接受精神科住院治疗的中重度抑郁症青少年的治疗体验。所有参与者(N = 1,624;Mage = 15.58,SD = 1.46)都是在 2020 年 1 月至 2022 年 3 月期间被一家大型、跨州的精神病院系统收治的。95.6%的患者为白人,99%为非西班牙裔,64.7%为女性。入院时,所有患者都接受了一项评估,其中包括多维行为健康筛查(BHS),该筛查可评估精神病理学和风险因素、工作联盟量表、抑郁和幸福感测量。患者还被问及他们是如何加入项目的,采用单项选择题作为非正式的治疗准备度量,得出三个准备度量组别:前考虑组、考虑组或准备组。回归分析结果表明,患者的准备程度与不同的基线特征(如年龄、性别、精神病理症状、风险因素)和第 3 周的结果(如症状减轻、幸福感、联盟、满意度)相关。本文将讨论其临床意义、局限性和未来发展方向。
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来源期刊
CiteScore
5.20
自引率
7.70%
发文量
50
期刊介绍: The aim of Administration and Policy in Mental Health and Mental Health Services is to improve mental health services through research. This journal primarily publishes peer-reviewed, original empirical research articles.  The journal also welcomes systematic reviews. Please contact the editor if you have suggestions for special issues or sections focusing on important contemporary issues.  The journal usually does not publish articles on drug or alcohol addiction unless it focuses on persons who are dually diagnosed. Manuscripts on children and adults are equally welcome. Topics for articles may include, but need not be limited to, effectiveness of services, measure development, economics of mental health services, managed mental health care, implementation of services, staffing, leadership, organizational relations and policy, and the like.  Please review previously published articles for fit with our journal before submitting your manuscript.
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