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Parenting programmes for behavioural problems: where do tertiary units fit in a comprehensive service?

Marina Beeson1, Ingrid Davison, Panos Vostanis

  • 1Child Adolescent and Family Service, Kettering, UK.

Clinical Child Psychology and Psychiatry
|November 4, 2006
PubMed

Insights

Children referred to tertiary services for behavioral issues exhibit greater complexity and comorbidity. These cases require specialized interventions after community services prove insufficient.

Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Clinical Psychology

Background:

  • Referrals for child behavioral problems often lack clear criteria, leading to inconsistent service allocation.
  • Understanding referral pathways and patient characteristics is crucial for effective child mental health service delivery.

Purpose of the Study:

  • To delineate the psychosocial characteristics of children with behavioral problems referred to a tertiary Day Resource.
  • To compare these characteristics with those referred to specialist outpatient services and community family support.

Main Methods:

  • Utilized demographic data, the Strengths and Difficulties Questionnaire (SDQ), and the Health of the Nations Outcome Scales for Children and Adolescents (HoNOSCA).
  • Compared patient profiles across three distinct service levels: tertiary Day Resource, specialist outpatient, and community family support.

Main Results:

  • Families referred to the Day Resource showed greater multi-agency involvement.
  • Children at the Day Resource presented with higher clinical severity and complexity, notably due to attention difficulties, communication issues, and physical health problems.
  • Findings supported the hypothesis of increased psychosocial needs and comorbidity in tertiary-level referrals.

Conclusions:

  • Tertiary services are justified for complex cases with significant comorbidity that do not respond to community-based interventions.
  • Specialized parenting interventions are necessary for these complex cases, emphasizing a tiered approach to care.
  • Clear referral rationalization and pathway definition are needed for child mental health services.

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