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: 7624307
• 负责人: J. Curtis MCMILLEN
• 金额: $ 19万
• 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 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7624307
• 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; Employment; Employment Opportunities; Epidemiology; Evidence based intervention; Evidence based treatment; Face; Family; Feedback; Future; Health Personnel; Healthcare; 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; Population; Process; Protocols documentation; Provider; Psychiatric Diagnosis; Psychiatric Nursing; Psychiatric therapeutic procedure; Psychiatrist; Randomized; 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; care systems; design; experience; foster care; foster home; foster parent; functional outcomes; improved; innovation; intervention effect; juvenile justice system; meetings; programs; protocol development; response; service intervention; severe mental illness; skills; social; therapy design; therapy development; treatment as usual; 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）：作为对RFA-MH-07-051的回应，本R34申请建议开发和试点测试一种干预措施，即有精神病学需求的老年青年治疗寄养（TFC-OY），旨在帮助有严重精神健康问题的老年青年向成年过渡。有严重精神健康问题的老年青年在离开儿童服务部门进入成年期时面临着重大挑战，但没有任何基于证据的干预措施来帮助他们过渡。在寄养和少年司法系统中，大多数有严重精神健康问题的青少年都生活在综合护理项目中。本申请拟以张伯伦的多维治疗寄养为基础，为生活在集体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。tbc - oy干预措施将a)将老年青年从集中护理环境中移出，b)将他们安置在治疗寄养家庭中，并向他们提供c)过渡规划，d)旨在澄清其精神状况并激励他们管理其精神保健的干预措施，以及e)就业机会和练习独立生活技能。多维治疗寄养将得到修改，为青年提供更多的选择和就业机会，并发展更多的退步选择，使其更独立地生活。将增加干预成分，以解决PI在初步研究中确定的老年青年的三个临床问题：a)需要更清楚地了解他们精神疾病的性质，b)需要了解他们的精神药物的目的和价值，以及c)当老年青年改变生活状况时，精神治疗缺乏连续性。在第2年，将随机抽取一小部分接受集体照顾的年长青年样本，接受6至9个月的tcf - oy或接受由住宿和儿童福利提供者提供的常规照顾服务。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，b)对干预中的潜在中介机制和调节变量提出假设，这些变量决定了干预何时以及对谁将成功。TFC-OY组和常规护理组将在基线、随机分组后6、12和18个月进行评估，以评估干预对功能结局（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。