Assessing the effectiveness of care for youth with severe emotional disturbances: is there agreement between popular outcome measures?

Limited information exists regarding how some popular measures for assessing the effectiveness of services to children with severe emotional disturbance interrelate when used as part of ongoing outcome accountability systems. This article examines the interrelationships--at intake and over time--between the Child Behavior Checklist (CBCL), the Youth Self Report (YSR), the Child and Adolescent Functional Assessment Scale (CAFAS), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) clinical diagnoses across six California care systems. At intake, there were mild to moderate relationships between the clinical diagnosis, the CAFAS, the CBCL, and the YSR. These relationships were not as strong as those found in other studies conducted in more controlled research environments. There was limited agreement among the CAFAS, the CBCL, and the YSR regarding the outcomes of the youths served. These findings raise questions regarding translating measures from research settings to clinical environments and reconciling differences between outcome measures.