Evaluating the effect of an adolescent in-patient and day treatment program on participants' self-efficacy and well-being : psychological outcomes and treatment process
Date
2003
Authors
Ruttan, Dale A.
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Abstract
Studies have been conducted evaluating program and service delivery quality of adolescent psychiatric hospitalizations. Few studies measure the effect treatment programs have on adolescent self-efficacy or well-being. Little research has been conducted to determine what the adolescent believes has been effective and how this satisfaction affects efficacious beliefs about self and overall mental well-being. The intent of this research was to conduct much needed participant-based research, highlighting the psychological effects of mental health treatment on the adolescent. This study focused on 19 psychiatric in-patient and day program adolescents in a Canadian mental health hospital. Through the Self-Efficacy Scale and the Bradburn Affect Balance Scale, quantitative data of self-efficacy and well-being were collected to measure treatment effect. A client satisfaction questionnaire was administered to obtain statistical satisfaction results to compare with mean scores of self-efficacy and well-being. Qualitative outcomes of the adolescent participants' treatment experience were obtained through semi-structured interviews, written information from the satisfaction questionnaire, and a follow-up focus group. A repeated measures design examined the quantitative scores of self-efficacy and well-being across three time periods: waitlist (T1), admission (T2), and discharge (T3). Contrasts were made between control and experimental periods, and, accordant with the hypotheses, tests of within subject factors showed T3 means of both self-efficacy and well-being were consistently higher than both waitlist and pre-treatment means. Adolescent self-efficacy and well-being were also directly correlated with higher levels of satisfaction. Adding to the quantitative information, and to enhance understanding of the effect and process of treatment on the adolescent, a Grounded Theory method was conducted to analyze the semi-structured interviews (M=20mins) on all participants. Twenty open-ended questions, exploring satisfaction, self-efficacy, well-being, and experiences, were examined with thematic interview results enriching the quantitative data obtained . A focus group was also conducted to elicit post-treatment reports of participant self-efficacy, well-being, satisfaction, and retrospection on treatment. Group participants reported high levels of satisfaction, improved self-efficacy, and increased emotional well-being after treatment. Implications and generalizations of the results, limitations found within the current research, and recommendations for future treatment and research in adolescent psychiatry are discussed.