WRMA Presents at University of South Florida Conference
Two WRMA employees recently presented papers at the University of South Florida’s Children’s Mental Health Research and Policy Conference, which took place March 4-7, 2012.
Carolyn Lichtenstein, a vice president at WRMA, presented a paper titled "Complex Trauma: Service Use and Outcomes." This analysis—which WRMA research manager Lisa Branton also played a significant role in—examined the nature and extent of complex trauma exposure and its symptoms among children served by the National Child Traumatic Stress Network (NCTSN). The NCTSN is a national network of centers funded by the Substance Abuse and Mental Health Services Administration and is devoted to improving mental health treatment for trauma. NCTSN treatment centers collected data between 2001 and 2010 on the children and adolescents they serve and submitted these data to a cross-site evaluation. The analyses focused on six aspects of complex trauma: 1) age of first trauma exposure; 2) number of years of exposure; 3) whether exposed to multiple types of trauma; 4) number of trauma types experienced (rather than witnessed or vicarious); 5) number of trauma types with repeat exposure; and 6) number of different trauma types to which exposed. Linear and logistic regression analyses examined the extent to which these variables predicted clinical status at intake and services provided.
Results regarding clinical status at intake suggest that 1) exposure to a larger number of different traumas is related to having more functional problems and a higher UCLA PTSD total score; 2) exposure to violent traumas is related to higher CBCL internalizing, UCLA PTSD total, and Trauma Symptom Checklist PTSD scores; and 3) trauma exposure starting at an earlier age is related to fewer functional problems and lower CBCL internalizing and externalizing scores. Results regarding service use suggest that girls are more likely to receive family therapy, and that children/youth who were exposed to trauma over a longer period of time were more likely to receive cognitive-based therapy.
Susan Drilea, a senior research associate at WRMA, also presented. Ms. Drilea's paper was titled “Patterns of Service Use, Costs, and Outcomes over Time in System of Care Communities” and discussed an investigation which analyzed data from the Services and Costs Study and Longitudinal Child and Family Outcomes Study, both conducted by the National Evaluation of the Children’s Mental Health Initiative. Data were analyzed on 37,958 service events received by 356 children and their caregivers. These system of care services included mental health, child welfare, physical health, and special education services. Ms. Drilea’s presentation explored patterns of service use and service costs, as well as child and caregiver outcomes over the first 18 months of system of care services. Child outcomes were measured using the Child Behavior Checklist Total Problem Score and the Behavioral and Emotional Rating Scale, while caregiver outcomes were measured using the Caregiver Strain Questionnaire.
Derived from summary statistics and linear regression, findings indicated that over time, service use and costs significantly decreased, while child and caregiver outcomes improved. The mean number of services received per child over time displayed a decreasing trend in both support services and therapeutic services, accompanied by a decreasing average total cost per child for both types of services. In contrast to these declining trends in service use and costs, child and caregiver outcomes demonstrated continued improvement, although the rate of improvement slowed over time.