Factor structure of the treatment outcome package for children

The Treatment Outcome Package (TOP) is a behavioral health assessment and outcome battery with modules that assess a wide array of behavioral health symptoms and functioning, demographics, case-mix variables, and treatment satisfaction. The TOP was developed to follow the design specifications set forth by the Core Battery Conference (Horowitz, Lambert, & Strupp, 1997), but also to ensure the battery's applicability to naturalistic treatment. The TOP also includes a child version that addresses recommendations recently voiced by several experts in youth assessment and treatment. The purpose of this manuscript is to document the process involved in developing the shortened version of the Child TOP. With large samples of diverse patients, 103 items were reduced to 48, with 13 stable and clinically useful subscales. The final confirmatory factor analysis of 7,267 patients replicated the model with excellent results. Although some of these subscales were similar to factors derived from the adult version of the TOP, others were specific to childhood disorders. In addition, the analyses demonstrated that the TOP is not restricted to manifestations of distress and impairment, but also captures a unique factor of childhood strengths (i.e., resiliency).