Therapy success in a child guidance center as a function of intake and treatment variables
The purposes of this investigation were to: (a) describe the Des Moines Child Guidance Center (DMCGC); (b) to relate demographic and intake variables with recommended treatment modality; (c) to relate demographic, intake and treatment variables with respective indices of treatment compliance and outcome; and (d) to use aggregates of demographic and intake variables to predict recommended treatment modality, compliance and outcome;Data of the DMCGC clientele and staff were derived from files of 303 cases opened during 1983 and closed by December 31, 1986;An analysis of clinicians' responses to rating scales of clients' functioning indicated that the clinician was a source of variability in the results;Descriptive results revealed that the typical client was a boy in the latency stage who presented problems with social or impulsive behaviors at school and home. The typical family seen was composed of divorced parents, with more than one child. Eighty-three percent of the families agreed with treatment recommendations, and 52% of the cases complied. Only 34% of the cases terminated contact with staff advice;No variables, except age, were significantly associated with recommended or with received treatment modality. Recommendation for treatment modalities was not related to demographic or psychological variables. Yet, clients judged to have lower levels of functioning were recommended to receive treatment more often than those judged to have higher levels;Clients complied with recommendations more often when they were seen at the Outreach program than at the main Center. Also, the longer clients had to wait for a first therapy appointment, the more frequently they complied with treatment recommendations;Treatment outcome was more positive when the client received play/parent therapy, and it was also better when clients were seen by the Outreach team. Treatment was more successful when clients had a greater number of therapy visits. Finally, when the clinician who conducted a family intake interview also offered to be the ongoing therapist, treatment outcome was more positive than in cases in which different clinicians served as intake worker and therapist;The positive results of the Outreach program were discussed, and implications of the above findings were proposed.