Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service

The aim of this paper is to examine the facets of parental satisfaction and its relationship with clinician-rated outcome in a child and adolescent mental health service.

Patients (n = 1278) consecutively assessed between 1992 and 1996 were included in the study. When treatment ended, clinicians rated the outcome of the intervention and parents were asked to complete a satisfaction questionnaire.

Sixty-nine per cent of cases were rated by clinicians as having a positive outcome. Outpatients were more likely to be given a positive rating than inpatients. Satisfaction questionnaires were returned by 40% of parents; 76% of these were mostly or very satisfied. Satisfaction scores increased with the number of outpatient sessions attended but did not differ between inpatients and outpatients. There was a significant but small agreement (27% better than chance) between clinicians' rating of outcome and parental satisfaction. Level of agreement varied according to service provided and the number of sessions attended. While rates of positive outcome increased over the study period, ratings of satisfaction were stable.

Overall, ratings of satisfaction were comparable with those reported in other studies. Variations in concordance between parents and clinicians show that outcome and satisfaction, although related, are different constructs influenced by different factors depending on the services provided. Focusing on specific aspects of satisfaction, as opposed to global measures, may be more useful for services, although such undertakings must be supported with efforts to improve clinical outcomes.