Relation of Family Functioning to Treatment Outcomes in Day and Residential Programs: A Clinical Study with Emotionally Disturbed Adolescents

by Shanker, Utpala

Residential and day facilities are important providers of treatment for seriously emotionally disturbed adolescents. The primary difference between the two types of treatment programs is that adolescents attending day treatment reside with their families while those in residential programs live at the treatment facility. Very few studies have addressed the relation of family functioning to treatment outcomes for adolescents. Furthermore, extant research has not investigated whether the relation of family functioning to treatment outcomes is different for adolescents in residential and day programs, This study proposed that adolescents from severely dysfunctional families at admission would have better outcomes in their social, educational, and overall functioning in residential treatment, and those from less severely dysfunctional families would make gains in day treatment. The sample included a total of 86 adolescents from day and residential programs. There were 43 adolescents from each treatment group, and the two groups were matched on age, gender, and level of family functioning. The results did not support the main hypotheses. However, univariate analyses revealed that the type of treatment program and the severity of dysfunction in families at admission were independently related to the outcome measures: social, educational, and overall functioning at discharge. Adolescents in the day program made significantly more gains in their social and overall functioning at discharge. Family functioning at admission was found to have a significant effect on the educational functioning of adolescents in both treatment groups at discharge. In addition, the covariate, length of stay, was found to be significantly related to the outcome measures. The findings from this study have important implications for the treatment of emotionally disturbed adolescents. The results Shanker, Utpala, 2008, UMSL, p.3 from this study highlight the significance of social skills training for emotionally disturbed adolescents. The findings also suggest that day and residential programs should consider the level of dysfunction in families as well as the benefits of gradually transitioning patients to the next level of care as important factors in treatment. Shanker, Utpala, 2008, UMSL, p.4