Abstract
We examined trajectories of symptom reduction during the course of on-site treatment for behavior problems in pediatric primary-care
settings for a subset of children from a larger clinical trial. Participants (N = 80) were children (ages 6–11) referred for treatment due to moderate elevations (≥75th percentile) on the externalizing
subscale of the Pediatric Symptom Checklist (PSC-17). The sample was recruited from six pediatric practices in an urban setting.
The treatment (Protocol for an Office-based Nurse-administered Intervention; PONI) was administered on-site by trained nurses over the course of 3–6 months. Overall, symptom reduction from
the first session to last session was moderate (ES = 0.61) and gradual. Roughly two-thirds (72%) of symptom reduction took place over the first 8 weeks of treatment. The average
trajectory of symptom reduction was characterized by a negative slope that flattened over time, consistent with a quadratic
growth model. Initial symptom severity predicted final symptom severity (r = .36, P < .01), even though patients with greater initial symptom severity remained in treatment for a significantly greater number
of sessions (r = .24, P < .05). The implications of these findings for enhancing the efficiency and effectiveness of treatment are discussed.
settings for a subset of children from a larger clinical trial. Participants (N = 80) were children (ages 6–11) referred for treatment due to moderate elevations (≥75th percentile) on the externalizing
subscale of the Pediatric Symptom Checklist (PSC-17). The sample was recruited from six pediatric practices in an urban setting.
The treatment (Protocol for an Office-based Nurse-administered Intervention; PONI) was administered on-site by trained nurses over the course of 3–6 months. Overall, symptom reduction from
the first session to last session was moderate (ES = 0.61) and gradual. Roughly two-thirds (72%) of symptom reduction took place over the first 8 weeks of treatment. The average
trajectory of symptom reduction was characterized by a negative slope that flattened over time, consistent with a quadratic
growth model. Initial symptom severity predicted final symptom severity (r = .36, P < .01), even though patients with greater initial symptom severity remained in treatment for a significantly greater number
of sessions (r = .24, P < .05). The implications of these findings for enhancing the efficiency and effectiveness of treatment are discussed.
- Content Type Journal Article
- Pages 1-9
- DOI 10.1007/s10488-011-0335-2
- Authors
- Oliver Lindhiem, Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O’Hara St, Pittsburgh, PA 15213, USA
- David J. Kolko, Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O’Hara St, Pittsburgh, PA 15213, USA
- Journal Administration and Policy in Mental Health and Mental Health Services Research
- Online ISSN 1573-3289
- Print ISSN 0894-587X