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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
Summary
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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