Mental health care in an adolescent medical setting

Two hundred sixty-four troubled adolescents referred to a medical adolescent clinic were randomly assigned to one of three therapies and to one of four conditions defined by whether treatment was delayed for 6 weeks or not, and whether or not the case was presented to a psychiatrist. Patients were assessed by parents and self-reports at intake and at 6, 12, and 24 weeks, using the Adolescent Life Assessment Check List (ALAC). This 40-item instrument yielded a total and six subscores. Patients in all treatment conditions showed improvement across time as measured by the ALAC (patient or parent). Improvement was noted for each race--sex group, for each of the four conditions, and for patients assigned to each therapist. Differences in outcome were noted for immediate vs. delay groups and for groups given psychiatric consultation. By 6 months, scores on the adolescent ALAC approximated those of a matched normative sample tested. Although successful, the program should be replicated before its findings are generalized.