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ABSTRACT: To assess the effectiveness of a community mental health center outpatient adolescent treatment program, outcome measures were completed by the parents of 50 consecutively admitted adolescent patients who were evaluated and treated with one of three therapy modalities. Their results were compared to outcome measures of 29 non-treated adolescent control subjects. Also, self-report outcome measures were completed by 30 treatment subjects. The results demonstrated a significant positive change in the study group following treatment as compared with the control group. Each of the treatment modalities used with the study group was associated with improvement. The staffing referral mechanism used to determine the particular treatment modality for each patient was shown to be consistently and appropriately implemented.
KEY WORDS: adolescent; anger management; community mental health center.
INTRODUCTION
Providing effective treatment is the central goal of community mental health centers (MHCs); in fact, determining effectiveness is vital for the continued existence of programs within community MHCs. Patients must objectively and functionally improve following treatment and the improvement must be shown to result, at least in part, from the treatment.
Treatment efficacy research has assisted in defining which treatments are likely to be the most helpful and effective with particular patient problems, i.e., which treatment approaches are evidence-based. However, treatment efficacy research is very different from treatment effectiveness research. The goal of efficacy studies is to reveal which particular treatment variables are associated with improvement of specific patient problems. Non-treatment variables are controlled in efficacy research. This is accomplished because trained research assistants conduct efficacy research in academic or research-based settings where structured treatment protocols are used with a pre-selected patient population (Jensen, Hoagwood, and Petti, 1996). In contrast, effectiveness research strives to assess whether previously tested treatments (via efficacy research) can be implemented effectively within a specific clinical setting, where non-treatment variables are not controlled (Hohmann and Shear, 2002). In fact, adaptations, modifications, and flexible applications of efficacy research or manual-based interventions are typical and necessary in "real world" clinics. As a result, transporting treatments shown to be efficacious in research settings to MHC settings does not guarantee effective results. There are simply too many issues contributing to patient outcome in MHCs to think that one method of delivering treatment, even if shown to...