Skip to main content

Family Involvement and Changes in Child Behavior During Residential Mental Health Treatment

Abstract

Background

Family involvement is viewed as an important component of the treatment process for children in residential treatment centers, but little is known about the impact of contact with family members on changes in youth functioning.

Objective

The goal of this study was to use administrative data to examine the association between family involvement and youth outcomes for a Medicaid-funded residential treatment program in Florida. Differences between in-person and telephone intervention contacts based on the proximity of the family residence to the program were also explored.

Methods

The sample was divided into two groups based on the number of family contacts per month during the treatment episode; i.e., number of family contacts equal to or less than the median and number of family contacts greater than the median. Generalized estimating equations were used to examine characteristics related to the percent change in scores on a measure of emotional and behavioral functioning.

Results

Results suggest that maternal and paternal contacts, as well as the total number of family contacts, were associated with greater improvements in youth functioning. Youth that resided in a different county than the residential program had greater improvement in behaviors when the family was involved regardless of whether contact was in-person or over the phone.

Conclusions

Family involvement, including phone contacts, is associated with improved youth outcomes during the treatment episode.

This is a preview of subscription content, access via your institution.

References

  • Achenbach, T. (1991). Manual for the child behavior checklist/4-18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Affronti, M. L., & Levinson-Johnson, J. (2009). The future of family engagement in residential care settings. Residential Treatment for Children & Youth, 26, 257–304.

    Article  Google Scholar 

  • American Association of Children’s Residential Centers. (2005). Redefining residential: One through eight. Retrieved from http://www.thinkkids.org/docs/Redefining.pdf.

  • Antonucci, T. C., Akiyama, H., & Takahashi, K. (2004). Attachment and close relationships across the life span. Attachment and Human Development, 6, 353–370.

    PubMed  Article  Google Scholar 

  • Armstrong, M., Dollard, N., Robst, J., Hummer, V., Li, W., Cobb, S., et al. (2010). Evaluation of Medicaid-funded out-of-home alternatives for FY 09–10. Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida.

    Google Scholar 

  • Baker, B. L., & Blacher, J. (2002). For better or worse? Impact of residential placement on families. Mental Retardation, 40, 1–13.

    PubMed  Article  Google Scholar 

  • Baker, B. L., Blacher, J., & Pfeiffer, S. (1993). Family involvement in residential treatment of children with psychiatric disorder and mental retardation. Hospital & Community Psychiatry, 44, 561–566.

    Google Scholar 

  • Blader, J. C. (2004). Symptom, family, and service predictors of children’s psychiatric rehospitalization within one year of discharge. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 440–451.

    PubMed  Article  Google Scholar 

  • Blau, G. M., Caldwell, B., Fisher, S. K., Kuppinger, A., Levison-Johnson, J., & Lieberman, R. (2010). The building bridges initiative: Residential and community-based providers, family, and youth coming together to improve outcomes. Child Welfare, 89(2), 21–38.

    PubMed  Google Scholar 

  • Bowlby, J. (1969/1982). Attachment and loss. New York, Basic Books.

  • Child Welfare League of America, Inc. (2004). CWLA standards of excellence for residential services. Washington, DC: Author.

    Google Scholar 

  • Frensch, K. M., & Cameron, G. (2002). Treatment of choice or a last resort? A review of residential mental health placements for children and youth. Child & Youth Care Forum, 31, 307–339.

    Article  Google Scholar 

  • Gorske, T. T., Srebalus, D. J., & Walls, R. T. (2003). Adolescents in residential centers: Characteristics and treatment outcomes. Children and Youth Services Review, 25(4), 317–326.

    Article  Google Scholar 

  • Greenbaum, P. E., & Dedrick, R. F. (1998). Hierarchical confirmatory factor analysis of the Child Behavior Checklist/4-18. Psychological Assessment, 10, 149–155.

    Article  Google Scholar 

  • Hair, H. J. (2005). Outcomes for children and adolescents after residential treatment: A review of research from 1993 to 2003. Journal of Child and Family Studies, 14(4), 551–575.

    Article  Google Scholar 

  • Hardin, J., & Hilbe, J. (2002). Generalized estimating equations. Danvers, MA: CRC Press.

    Book  Google Scholar 

  • Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52, 1179–1189.

    PubMed  Article  Google Scholar 

  • Jenson, J. M., & Whittaker, J. K. (1987). Parental involvement in children’s residential treatment. Children and Youth Services Review, 9, 81–100.

    Article  Google Scholar 

  • Kahn, R. L., & Antonucci, T. C. (1980). Convoys over the life course: Attachment, roles, and social support. In P. B. Baltes & O. G. Brim (Eds.), Life-span development and behavior (Vol. 3, pp. 253–286). New York, NY: Academic Press.

    Google Scholar 

  • Kruzich, J. M., Jivanjee, P., Robinson, A., & Friesen, B. J. (2003). Family caregivers’ perceptions of barriers to and support of participation in their children’s out-of-home treatment. Psychiatric Services, 54, 1513–1518.

    PubMed  Article  Google Scholar 

  • Lakin, B. L., Brambila, A. D., & Sigda, K. B. (2004). Parental involvement as a factor in the readmission to a residential treatment center. Residential Treatment for Children & Youth, 22(2), 37–52.

    Article  Google Scholar 

  • Leathers, S. J. (2002). Parental visiting and family reunification: Could inclusive practice make a difference? Child Welfare, 81, 595–616.

    PubMed  Google Scholar 

  • Lee, L. J. (2011). Adult visitation and permanency for children following residential treatment. Children and Youth Services Review, 33(7), 1288–1297.

    Article  Google Scholar 

  • Levitt, M. J., Levitt, J., Bustos, G. L., Crooks, N. A., Santos, J. D., Telan, P., et al. (2005). Patterns of social support in the middle childhood to early adolescent transition: Implications for adjustment. Social Development, 14, 398–420.

    Article  Google Scholar 

  • McWey, L. (2000). I promise to act better if you let me see my family: Attachment theory and foster care visitations. Journal of Family Social Work, 5, 91–105.

    Article  Google Scholar 

  • Stage, S. A. (1999). Predicting adolescents’ discharge status following residential treatment. Residential Treatment for Children and Youth, 16(3), 37–56.

    Article  Google Scholar 

  • Sunseri, P. A. (2001). The prediction of unplanned discharge from residential treatment. Child & Youth Care Forum, 30, 283–303.

    Article  Google Scholar 

  • Sunseri, P. A. (2004). Family functioning and residential treatment outcomes. Residential Treatment for Children and Youth, 22(1), 33–53.

    Article  Google Scholar 

  • Walter, U. M., & Petr, C. G. (2008). Family-centered residential treatment: Knowledge, research, and values converge. Residential Treatment for Children & Youth, 25(1), 1–16.

    Article  Google Scholar 

  • Wells, K., Wyatt, E., & Hobfoll, S. (1991). Factors associated with adaptation of youths discharged from residential treatment. Children and Youth Services Review, 13, 199–216.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John Robst.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Robst, J., Rohrer, L., Armstrong, M. et al. Family Involvement and Changes in Child Behavior During Residential Mental Health Treatment. Child Youth Care Forum 42, 225–238 (2013). https://doi.org/10.1007/s10566-013-9201-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10566-013-9201-6

Keywords

  • Residential treatment
  • Child behavior
  • Family involvement
  • Treatment outcomes