Treatment Foster Care for Older Youth with Psychiatric Needs

对有精神需求的老年青少年的治疗寄养

• 批准号: 7483578
• 负责人: J. Curtis MCMILLEN
• 金额: $ 26.69万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-15 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7483578
• 关键词: Address; Adult; Belief; Build-it; Caring; Child; Child Welfare; Climacteric; Clinical; Clinical Services; Clinical Trials; Communities; Confusion; Criminal Justice; Development; Diagnostic; Disadvantaged; Disease; Education; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Employment; Employment Opportunities; Evidence based intervention; Evidence based treatment; Face; Family; Feedback; Future; Health Personnel; Home environment; Hospitalization; Income; Independent Living; Intervention; Interview; Investments; Knowledge; Lead; Learning; Left; Life; Manuals; Maps; Mediating; Mental Health; Modeling; Modification; Motivation; Nature; Nurse Psychotherapist; Nurses; Oregon; Outcome; Participant; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacotherapy; Phase; Placement; Population; Process; Protocols documentation; Provider; Psychiatric Diagnosis; Psychiatric Nursing; Psychiatric therapeutic procedure; Psychiatrist; Purpose; Pyrococcus kodakaraensis TIP protein; Randomized; Rate; Recording of previous events; Recovery; Recruitment Activity; Research; Residential Facilities; Residential Treatment; Sampling; Schools; Services; Social Welfare; Staging; Structure; Symptoms; System; Testing; Training Support; Treatment Protocols; Work; Youth; base; design; experience; foster care; foster home; foster parent; functional outcomes; improved; innovation; juvenile justice system; programs; protocol development; response; service intervention; severe mental illness; size; skills; social; therapy design; therapy development; treatment program

DESCRIPTION (provided by applicant): In response to RFA-MH-07-051, this R34 application proposes to develop and pilot test an intervention, Treatment Foster Care for Older Youth with Psychiatric Needs (TFC-OY), designed to assist older youth with serious mental health problems who are in transition to adulthood. Older youth with serious mental health problems face substantial challenges as they leave child-serving sectors of care and move into adulthood, yet no evidence-based intervention exists to assist in this transition. In the foster care and juvenile justice systems, most youth with serious mental health problems live in congregate care programs. This application proposes to develop an intervention for older youth with serious mental health problems who live in congregate care using Chamberlin's multidimensional treatment foster care as a base for adaptation. The TFC-OY intervention will a) remove older youth from congregate care settings, b) place them in a treatment foster care family, and provide them with c) transitional planning, d) interventions designed to clarify their psychiatric status and motivate them to manage their mental health care, and e) opportunities for employment and to practice independent living skills. Multidimensional treatment foster care will be modified to provide more opportunities for youth choice, employment and to develop additional step-down options into more independent living. Intervention components will be added that address three clinical issues of older youth identified in preliminary research conducted by the PI: a) a need for greater clarity on the nature of their psychiatric illnesses, b) a need to understand the purpose and value of their psychotropic medications, and c) a lack of continuity in psychiatric treatment when older youth change living situations. In year two, a small sample of older youth in congregate care will be randomized to receive TFC-OY for six to nine months or to receive usual care services provided by residential and child welfare providers. TFC-OY will be qualitatively studied to a) assess issues of acceptability, tolerability and feasibility of the intervention, and b) develop hypotheses about potential mediating mechanisms within the intervention and moderating variables that determine when and for whom the intervention will be successful. The TFC-OY and usual care groups will be assessed at baseline, and 6, 12, and 18 months following randomization to assess the effects of the intervention on functional outcomes (education, employment, criminal system involvement), service use, and psychiatric symptoms. Presuming encouraging results, we will modify TFC-OY based on our findings and submit an R01 application to study its effectiveness.

描述(由申请人提供)：针对RFA-MH-07-051，这份R34申请建议开发和试点测试一种干预措施，即治疗寄养照顾有精神需求的老年青年(TFC-Oy)，旨在帮助处于成年期的有严重心理健康问题的老年青年。有严重精神健康问题的老年青年在离开儿童护理部门进入成年期时面临着巨大的挑战，但没有任何循证干预措施来协助这一过渡。在寄养和少年司法系统中，大多数有严重心理健康问题的青年生活在集体照料方案中。这项申请建议为生活在会众护理中的有严重心理健康问题的老年青年开发一种干预措施，使用张伯林的多层面治疗寄养作为适应的基础。TFC-Oy干预措施将a)将老年青年从聚集照料环境中移走，b)将他们安置在治疗寄养家庭，并为他们提供c)过渡规划，d)旨在澄清他们的精神状况并激励他们管理其心理保健的干预措施，e)就业机会和练习独立生活技能。将对多维治疗寄养进行修改，为青年提供更多的选择和就业机会，并为更独立的生活制定更多的逐步减少的选择。将增加干预部分，以解决PI进行的初步研究中确定的三个年长青年的临床问题：(A)需要更清楚地了解他们精神疾病的性质，(B)需要了解他们服用精神药物的目的和价值，以及(C)当年长青年改变生活情况时，精神治疗缺乏连续性。在第二年，我们会随机抽取一小部分接受社区照顾的年长青少年，让他们接受为期六至九个月的TFC-Oy服务，或接受院舍和儿童福利机构提供的一般照顾服务。将对TFC-OY进行定性研究，以a)评估干预的可接受性、耐受性和可行性问题，以及b)制定关于干预内潜在调解机制的假设，以及决定干预何时成功以及对谁有效的调节变量。TFC-OY组和常规护理组将在基线、随机分组后的6个月、12个月和18个月进行评估，以评估干预对功能结果(教育、就业、犯罪系统参与)、服务使用和精神症状的影响。假设结果令人鼓舞，我们将根据我们的发现对TFC-OY进行修改，并提交R01申请以研究其有效性。