In-Home, Family-Centered Psychiatric Treatment for High-Risk Children and Youth

In-home services are a core component of family preservation services and were developed as an alternative to out-of-home placement for children and adolescents in need of intensive psychosocial intervention. Extant studies that evaluate the effectiveness of in-home service have been criticized because they often do not use reliable and valid outcome measures. In this study we describe and evaluate an in-home program used by a large multistate health care organization in the Rocky Mountain region. An outcome measure that is currently being used by several managed care companies, the Youth Outcome Questionnaire (Burlingame, Wells, & Lambert, 1995), was used to objectively evaluate response to treatment in 104 patients ranging in age from 4 to17 who received in-home care. Using Jacobson and Truax's (1991) method, 62% of these patients demonstrated reliable improvement and 28% were classified as meeting the recovery criterion. Fiscal, patient care, and future research implications for in-home care are explored.