AIM: Engagement is critical in ensuring that the most 'at risk' clients receive care from psychiatric services, but the relationship between engagement and treatment outcomes remains unclear. This study investigated possible improvements in client engagement and the relationship between engagement and treatment outcomes in a group of difficult-to-engage, 'high-risk' young people seen by the Intensive Mobile Youth Outreach Service (IMYOS) in Western Metropolitan Melbourne, Australia. METHODS: Data from standardized outcome measures on client engagement, suicidality, hostility, well-being and functioning obtained at referral, after initial assessment and at discharge, were analysed retrospectively. RESULTS: Improved engagement was achieved after initial assessment and remained steady at discharge. All outcome measures showed significant improvement at discharge. Higher overall engagement following assessment was associated with decreased hostility risk and greater well-being and functioning at discharge. The engagement dimensions 'collaboration', 'perceived usefulness' and 'client-therapist interaction' were most consistently associated with better treatment outcomes. CONCLUSION: Engagement at an early stage of treatment can be a useful predictor for later hostility risk, well-being and functioning. To promote better outcomes for difficult-to-engage youth, service delivery needs to focus on collaborative client involvement, the development of a 'strong' therapeutic alliance and individualization of treatment in regard to client needs.
AIM: Engagement is critical in ensuring that the most 'at risk' clients receive care from psychiatric services, but the relationship between engagement and treatment outcomes remains unclear. This study investigated possible improvements in client engagement and the relationship between engagement and treatment outcomes in a group of difficult-to-engage, 'high-risk' young people seen by the Intensive Mobile Youth Outreach Service (IMYOS) in Western Metropolitan Melbourne, Australia. METHODS: Data from standardized outcome measures on client engagement, suicidality, hostility, well-being and functioning obtained at referral, after initial assessment and at discharge, were analysed retrospectively. RESULTS: Improved engagement was achieved after initial assessment and remained steady at discharge. All outcome measures showed significant improvement at discharge. Higher overall engagement following assessment was associated with decreased hostility risk and greater well-being and functioning at discharge. The engagement dimensions 'collaboration', 'perceived usefulness' and 'client-therapist interaction' were most consistently associated with better treatment outcomes. CONCLUSION: Engagement at an early stage of treatment can be a useful predictor for later hostility risk, well-being and functioning. To promote better outcomes for difficult-to-engage youth, service delivery needs to focus on collaborative client involvement, the development of a 'strong' therapeutic alliance and individualization of treatment in regard to client needs.
Authors: Helen Herrman; Cathy Humphreys; Stephen Halperin; Katherine Monson; Carol Harvey; Cathrine Mihalopoulos; Susan Cotton; Penelope Mitchell; Tony Glynn; Anne Magnus; Lenice Murray; Josef Szwarc; Elise Davis; Sophie Havighurst; Patrick McGorry; Sam Tyano; Ida Kaplan; Simon Rice; Kristen Moeller-Saxone Journal: BMC Psychiatry Date: 2016-12-07 Impact factor: 3.630
Authors: Marieke Broersen; Nynke Frieswijk; Hans Kroon; Ad A Vermulst; Daan H M Creemers Journal: Front Psychiatry Date: 2020-11-25 Impact factor: 4.157
Authors: Mary L Quinton; Grace Tidmarsh; Benjamin J Parry; Jennifer Cumming Journal: Int J Environ Res Public Health Date: 2022-09-08 Impact factor: 4.614