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Integrated, Family-based, Partial Hospital Treatment for Complex Pediatric Illness
Thomas A Roesler1, Jack H Nassau2, Michelle L Rickerby2
1Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.
Insights
This unique pediatric partial hospital program empowers families to manage complex illnesses. It integrates family systems, care, and a partial hospital setting for improved outcomes in children with treatment-resistant conditions.
Area of Science:
- Pediatric Medicine
- Family Systems Psychology
- Healthcare Management
Background:
- Complex pediatric illnesses often resist standard outpatient and inpatient treatments.
- Over 2000 children with diverse diagnoses have been treated, indicating a broad applicability.
- Family beliefs and distress can significantly impede treatment success in pediatric care.
Purpose of the Study:
- To describe a unique treatment program for complex pediatric illness.
- To evaluate the effectiveness of a family systems orientation, integrated care, and partial hospital setting.
- To empower children and families to gain control over chronic or complex illnesses.
Main Methods:
- Utilized a multidisciplinary team functioning as a 'meta-family'.
- Integrated family systems orientation, comprehensive care, and a partial hospital setting.
- Focused on modifying family explanatory models of illness and treatment participation.
Main Results:
- The program addresses over 80 different ICD-9 diagnoses in children.
- Families reported significant emotional distress, low functioning, and poor quality of life at intake.
- Families responded similarly to the experience of a seriously ill child, irrespective of the child's specific diagnosis.
Conclusions:
- A program addressing both specific pediatric diseases and non-categorical family responses to illness is effective.
- The integrated approach fosters an environment for families to modify beliefs and engage in effective medical care.
- Empowering both children and parents leads to favorable treatment responses in complex pediatric illness.
Abstract:
This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD-9 diagnoses. The multidisciplinary treatment team functions as a meta-family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.
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