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Clinical Child Psychology and Psychiatry, Vol. 4, No. 2, 201-213 (1999)
DOI: 10.1177/1359104599004002006

What Changes are of Value in Severely Disturbed Children?

Andrew Wiener

Hemel Hempstead Child & Family Consultation & Therapy Centre, The Marlowes

Keri Withers

Hemel Hempstead Child & Family Consultation & Therapy Centre, The Marlowes

Matthew Patrick

Hemel Hempstead Child & Family Consultation & Therapy Centre, The Marlowes

Elizabeth Bradley

Hemel Hempstead Child & Family Consultation & Therapy Centre, The Marlowes

Useful outcome research must use measures that are relevant to the clinical group in question. A literature review identified that little effort has been made to identify which areas of outcome are important for severely disturbed children with complex disorders, who are in day treatment. For a group of such children attending a psychiatric–educational day unit, this study set out to identify, at a qualitative level, which areas of change were valued by carers, teachers and clinicians. The results suggest that for children with severe psychiatric and educational problems a useful intervention need not involve large changes in the child. It was more important that the child’s informal and formal care network: carers, teachers, clinical staff and the professionals in other agencies, were able to reach a common understanding of the child’s difficulties, develop similar expectations of the child’s needs, and be able to agree on appropriate future plans for the child.

Key Words: outcome • partial hospitalization • primary school age children


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