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Administration and Policy in Mental Health and Mental Health Services Research

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01-07-2015 | Original Article

Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-harm

Authors: Sigrid James, Kim R. Freeman, Danessa Mayo, Matt L. Riggs, Joshua P. Morgan, Mary Ann Schaepper, Susanne B. Montgomery

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 4/2015

Abstract

This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents (n = 55 and n = 45), ages 12–18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT’s effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT.

We also analyzed clinical functioning trajectories using hierarchical linear modeling. Since HLM analysis did not detect variability in the slopes by key covariates, but only differences in the intercepts thereby confirming results presented here, we opted to use the analysis of variance approach to capture pre-post differences in outcome.

There was a negligible effect of funding type on Interpersonal Relations; however, baseline differences had previously been determined between privately funded and grant-funded youth. Subsequent linear regression with this variable, using the posttest score as the DV and controlling for pretest score indicated no effect of funding.

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Title: Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-harm
Authors: Sigrid James
Kim R. Freeman
Danessa Mayo
Matt L. Riggs
Joshua P. Morgan
Mary Ann Schaepper
Susanne B. Montgomery
Publication date: 01-07-2015
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 4/2015
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-014-0588-7

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Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-harm

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