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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-11-2011 | Original Paper

Trajectories of Symptom Reduction During Treatment for Behavior Problems in Pediatric Primary-Care Settings

Authors: Oliver Lindhiem, David J. Kolko

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 6/2011

Abstract

We examined trajectories of symptom reduction during the course of on-site treatment for behavior problems in pediatric primary-care settings for a subset of children from a larger clinical trial. Participants (N = 80) were children (ages 6–11) referred for treatment due to moderate elevations (≥75th percentile) on the externalizing subscale of the Pediatric Symptom Checklist (PSC-17). The sample was recruited from six pediatric practices in an urban setting. The treatment (Protocol for an Office-based Nurse-administered Intervention; PONI) was administered on-site by trained nurses over the course of 3–6 months. Overall, symptom reduction from the first session to last session was moderate (ES = 0.61) and gradual. Roughly two-thirds (72%) of symptom reduction took place over the first 8 weeks of treatment. The average trajectory of symptom reduction was characterized by a negative slope that flattened over time, consistent with a quadratic growth model. Initial symptom severity predicted final symptom severity (r = .36, P < .01), even though patients with greater initial symptom severity remained in treatment for a significantly greater number of sessions (r = .24, P < .05). The implications of these findings for enhancing the efficiency and effectiveness of treatment are discussed.

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Title: Trajectories of Symptom Reduction During Treatment for Behavior Problems in Pediatric Primary-Care Settings
Authors: Oliver Lindhiem
David J. Kolko
Publication date: 01-11-2011
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 6/2011
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-011-0335-2

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Trajectories of Symptom Reduction During Treatment for Behavior Problems in Pediatric Primary-Care Settings

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