The primary objectives of this research study are twofold a) to develop and pilot test a multifaceted system to assess the quality of implementation of a manualized treatment intervention for youth in residential care and b) to conduct a preliminary examination of the influence of treatment implementation on youth mental health outcomes. In comparison to less restrictive placements, youth in residential care are more likely to have dual clinical diagnoses, attempt or threaten suicide, or have significant impairments in psychological and social functioning. While the majority of youth in residential care have significant mental health needs, little is known about the treatment services provided or the effectiveness of the care received. The investigative team has identified four primary aims for the project:
(Aim 1) develop a multifaceted assessment approach to efficiently measure the implementation of the Teaching Family Model (TFM);
(Aim 2) assess the feasibility of administration and evaluate the preliminary psychometric properties of the implementation assessment instruments via a small-scale pilot study;
(Aim 3) examine the relationships between treatment implementation, common process factors, and staff and youth characteristics;
and (Aim 4) investigate the feasibility of collecting implementation data and examining the effects on youth mental health outcomes in a residential care facility. In order to accomplish these aims, the project will be carried out in two distinct phases. Phase I will address the first goal of developing an implementation assessment system that will measure the key components of the TFM model from a variety of key stakeholder perspectives (supervisors, staff, youth, and expert observers). During Phase I measures of common therapeutic processes will be revised for use in a youth residential group home setting. Phase II will include a pilot test of the newly developed measures to obtain preliminary information on their psychometric properties and feasibility of use in a practice setting. This will include assessing implementation adherence and competence and common therapeutic process factors in a residential setting. It is expected that approximately 135 youth and 120 staff will participate in this pilot study. Using structural equation models a confirmatory factor analyses will be conducted on the measurement model to determine the psychometric properties of the instruments. Likewise, multilevel analyses will be used to examine the relationship among implementation, common process factors, and youth mental health outcomes such as diagnostic disorders, behavioral and emotional status, critical behavioral incidents during care, and psychotropic prescriptions. It is anticipated that this proposed pilot study will provide essential instrument and procedure development and pilot testing for a future line of research examining the effectiveness of residential care service delivery for youth with mental health needs.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Study Section
Mental Health Services in MH Specialty Settings (SRSP)
Program Officer
Sherrill, Joel
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University of Nebraska Lincoln
Schools of Education
United States
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Duppong Hurley, Kristin; Van Ryzin, Mark J; Lambert, Matthew et al. (2015) Examining Change in Therapeutic Alliance to Predict Youth Mental Health Outcomes. J Emot Behav Disord 23:90-100
Hurley, Kristin Duppong; Lambert, Matthew C; Stevens, Amy (2015) Psychometrics of the Symptoms and Functioning Severity Scale for High-Risk Youth. J Emot Behav Disord 23:206-214
Duppong Hurley, Kristin; Lambert, Matthew C; Epstein, Michael H et al. (2015) Convergent Validity of the Strength-Based Behavioral and Emotional Rating Scale with Youth in a Residential Setting. J Behav Health Serv Res 42:346-54
Lambert, Matthew C; Hurley, Kristin Duppong; Gross, Thomas J et al. (2015) Validation of the symptoms and functioning severity scale in residential group care. Adm Policy Ment Health 42:356-62
Gross, Thomas J; Hurley, Kristin Duppong; Lambert, Matthew C et al. (2015) Psychometric Evaluation of the Symptoms and Functioning Severity Scale (SFSS) Short Forms with Out-of-Home Care Youth. Child Youth Care Forum 44:239-249
Lambert, Matthew C; Hurley, Kristin Duppong; Tomlinson, M Michele Athay et al. (2013) Measurement Properties of the Motivation for Youth Treatment Scale with a Residential Group Home Population. Child Youth Care Forum 42:
Duppong Hurley, Kristin; Lambert, Matthew C; Van Ryzin, Mark et al. (2013) Therapeutic Alliance Between Youth and Staff in Residential Group Care: Psychometrics of the Therapeutic Alliance Quality Scale. Child Youth Serv Rev 35:56-64